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Early acute aortic dissection of the donor aorta after orthotopic heart transplantation

Department of Cardiac Surgery, University Hospital 12 de Octubre, Madrid, Spain

*Corresponding author. C/La Alcazaba n° 2 3°Dcha, Madrid, 28041, España. Tel.: +34-651566239.

E-mail address: carlosestebanmartin{at}hotmail.com (C.E. Martin Lopez).

Acute type A aortic dissection is an uncommon complication after orthotopic heart transplantation and usually affects the native aorta. Seven cases reported in the literature describe an aortic dissection confined to the donor aorta and only in two of them were they detected during the early postoperative period. We describe the case of a 58-year-old man, the recipient of a cardiac allograft for ischemic cardiomyopathy 20 days earlier, who presented an acute type A aortic dissection limited to the donor aorta. Transesophageal echocardiography revealed severe aortic regurgitation and an intimal tear 2 cm above commissures. The patient was successfully treated with a composite valve graft. This case is the first successful repair in a cardiac allograft with acute aortic dissection of the donor aorta during the early postoperative period using a Bentall procedure.

Key Words: Aortic dissection; Heart transplantation