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J Thorac Cardiovasc Surg 2004;128:749-750
© 2004 The American Association for Thoracic Surgery

Brief communication

Is coma an absolute contraindication for emergency central aortic operation?

^a Department of Emergency and Critical Care Medicine, Kansai Medical University, Osaka, Japan

Received for publication March 1, 2004; accepted for publication March 22, 2004.

^* Address for reprints: Hirofumi Fujii, MD, Department of Emergency and Critical Care Medicine, Kansai Medical University, 10-15 Fumozonocho, Moriguchi, Osaka 570-8507, Japan
fujiih@takii.kmu.ac.jp

The first 20% of the full text of this article appears below.

Generally, acute aortic dissection complicated with a cerebrovascular event is a contraindication to emergency central aortic surgery because of poor postoperative prognosis.^1,2 However, we report a fully recovered case after an emergency operation for acute Stanford type A aortic dissection after the patient fell into a coma caused by brain malperfusion.

Clinical summary

The patient was a 79-year-old man. Left hemiplegia and loss of consciousness developed suddenly, and he was transferred to our emergency center under suspicion of brain infarction. On admission, his Glasgow coma scale was E1 V1 M1. Although brain computed tomography (CT) revealed no abnormal finding except for atrophy, body enhanced CT confirmed acute Stanford type A aortic dissection complicated with brain malperfusion caused by extension of the dissected flap to the innominate artery. Four . . . [Full Text of this Article]

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