REPAIR OF ACUTE DISSECTION OF THE ASCENDING AORTA ASSOCIATED WITH AORTIC COARCTATION

A 54-year-old man with coarctation of the thoracic aorta and acute dis section of the ascending aorta ruptured into the pericardium underwent emergency repair of the dissection by means of replacement of the asc ending aorta and the aortic valve. Correction of the aortic coarctatio n was performed 4 months later. The authors examine the special proble ms encountered in the treatment of this infrequent clinical emergency, which include decisions on the optimal sequence and timing of repair, on the best surgical exposure, and on the technique and adequacy of c irculatory support (especially the choice of the arterial cannulation site).