Successful Repair of Iatrogenic Acute Aortic Dissection With Cerebral Malperfusion

We describe the successful treatment of a patient with iatrogenic acute aortic dissection including cerebral malperfusion as a complication of coronary artery surgery. After beginning cardiopulmonary bypass, a retrograde ascending aortic dissection associated with cerebral malperfusion was recognized. Systemic circulation was immediately arrested at 31°C. After aortotomy, hypothermic selective antegrade cerebral perfusion was established. Replacement of the ascending aorta with coronary artery bypass grafting was performed without neurologic complications.