Deep Surgical Site Infection after Spinal Surgery with Instrumentation : Investigation of Degenerative Thoracolumbar Disorders and Osteoporotic Vertebral Collapse Cases, A Multi-Center Study

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  • Isoda Susumu
    Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitamam, Japan
  • Osako Motohiko
    Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitamam, Japan
  • Kimura Tamizo
    Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitamam, Japan
  • Mashiko Yuji
    Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitamam, Japan
  • Yamanaka Nozomu
    Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitamam, Japan
  • Nakamura Shingo
    Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitamam, Japan
  • Maehara Tadaaki
    Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitamam, Japan

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タイトル別名
  • Coronary Malperfusion due to Flap Suffocation after Acute Type A Dissection Surgery

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A 24-year-old man presented with chest pain. He was diagnosed as having a type A acute aortic dissection and an annulo-aortic aneurysm. After emergency surgery for an aortic root replacement, his electrocardiogram showed ST-segment depression and T-wave inversion. Echocardiography showed asynergy of the left ventricle without coronary ostial pathology. Heart catheterization revealed no coronary stenosis, but the true lumen of the residual ascending aorta had extreme diastolic narrowing due to flap suffocation. This resulted in coronary malperfusion. The pullback pressure curve confirmed the mechanism. The patient underwent a surgical re-intervention for a total arch repair, which diminished the coronary malperfusion. At a follow-up appointment four years and four months later, the patient was doing well.

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