Acute type A aortic dissection involving the left main trunk of the coronary artery - A report of two successful cases

This report describes 2 cases of a type A acute aortic dissection combined with myocardial infarction caused by a retrograde dissection into the left main trunk of the coronary artery. Successful surgical treatments, includin g the replacement of the ascending aorta, aortic valve resuspension and cor onary artery bypass grafting, were performed in both patients, and they rec overed well from cardiogenic shock. However, left ventricular function of b oth patients remained depressed postoperatively, which limited their qualit y of life. Because no definite method for salvaging infarcted myocardium ha s yet been established, either more timely surgery or the preoperative plac ement of a perfusion catheter in the left main coronary artery is mandatory .