Key result
One-stage surgery with ECMO support results in successful discharge for patients with ATAAD and AMI.
Why the study?
Acute myocardial infarction is a serious complication of acute type A aortic dissection that markedly increases mortality, but simultaneous treatment strategies remain controversial.
Does one-stage surgery for coronary revascularization and central aortic repair supported by ECMO improve survival in patients with acute type A aortic dissection complicated by acute myocardial infarction?
Case Report (n=3)
No
Does one-stage surgery for coronary revascularization and central aortic repair supported by ECMO improve survival in patients with acute type A aortic dissection complicated by acute myocardial infarction?
One-stage surgery for coronary revascularization and central aortic repair supported by ECMO can be a life-saving strategy for patients with acute type A aortic dissection complicated by acute myocardial infarction.
Supports feasibility in select ATAAD-AMI cases; leaves open survival benefit and requires prospective validation.
Background: Acute myocardial infarction (AMI) is one of the most serious complications of acute type A aortic dissection (ATAAD) and markedly increases patient mortality. Simultaneous treatment strategies remain controversial. How to improve the treatment of these patients remains a critical challenge for cardiovascular surgeons. Case presentation: All three patients who experienced chest pain were admitted to emergency department of our hospital. The 12-lead electrocardiogram revealed ST-segment depression, myocardial enzyme levels were significantly elevated. Emergency physicians diagnosed ATAAD with AMI, and emergency surgery was planned in collaboration with the cardiovascular surgery team. One-stage surgery for coronary revascularization and central aortic repair were performed, extracorporeal membrane oxygenation (ECMO) was implanted, ECMO was discontinued when hemodynamics stabilized. The patient ultimately recovered well and was discharged. Conclusion: For ATAAD combined with right ventricular AMI, one-stage surgery for coronary revascularization and central aortic repair, supported by ECMO as bridge, can be life-saving treatment strategy, the prognosis for all three patients was excellent.
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Xia et al. (2025) conducted a case report in Acute type A aortic dissection complicated with acute myocardial infarction (n=3). One-stage surgery for coronary revascularization and central aortic repair supported by ECMO was evaluated on Prognosis and recovery. One-stage surgery for coronary revascularization and central aortic repair supported by ECMO resulted in excellent prognosis and successful discharge for all three patients with ATAAD and AMI.
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