Management of type a aortic dissection complicated by coronary ischemia

Abstract

We read with great interest the article by Doguet et al. concerning the successful use of extracorporeal membrane oxygenation (ECMO) in a patient operated for acute type A aortic dissection (AAAD) and suffering from myocardial ischemia due to the dissection of the right coronary cusp [1]. Myocardial ischemia secondary to AAAD is known to dramatically increase the mortality associated with surgical repair. However, there are two points regarding the surgical management the authors described that we would like to comment upon.