{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:58:08Z","timestamp":1785772688256,"version":"3.56.0"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Severe myocardial failure after acute type A aortic dissection is usually attributed to structural coronary malperfusion. We report catastrophic global left ventricular failure despite preserved epicardial coronary anatomy, successfully bridged with durable mechanical circulatory support. A 57-year-old man presented with acute type A dissection and cardiogenic shock with extensive precordial ST-segment elevation. Emergency total arch replacement with a frozen elephant trunk was performed. Intraoperative inspection and postoperative coronary angiography confirmed patent coronary ostia and arteries. Postoperatively, venoarterial extracorporeal membrane oxygenation and a percutaneous microaxial flow pump was instituted; extracorporeal membrane oxygenation was weaned on day 4, but the patient remained pump-dependent. Perfusion imaging showed extensive fixed defects in the left coronary distribution, and durable left ventricular assist device implantation was required 6 weeks later. Severe myocardial injury can occur in acute type A aortic dissection without demonstrable fixed coronary obstruction. When dysfunction persists after successful repair, early viability assessment is essential to guide timely transition to durable mechanical circulatory support.<\/jats:p>","DOI":"10.1093\/icvts\/ivag204","type":"journal-article","created":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T11:34:15Z","timestamp":1784460855000},"source":"Crossref","is-referenced-by-count":0,"title":["Left Ventricular Failure Despite Patent Coronary Arteries in Acute Type A Aortic Dissection"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9679-5799","authenticated-orcid":false,"given":"Daisuke","family":"Nakatsuka","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Nara Prefecture General Medical Center , Nara 630-8581,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Nara Prefecture General Medical Center , Nara 630-8581,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Tara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Nara Prefecture General Medical Center , Nara 630-8581,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasumasa","family":"Tsukamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center , Suita 564-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026080311363019600_ivag204-B1","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1016\/S0003-4975(03)00899-3","article-title":"Coronary malperfusion due to type a aortic dissection: mechanism and surgical management","volume":"76","author":"Kawahito","year":"2003","journal-title":"Ann Thorac Surg"},{"key":"2026080311363019600_ivag204-B2","doi-asserted-by":"crossref","first-page":"829","DOI":"10.2169\/internalmedicine.49.3192","article-title":"Coronary spasm due to type a aortic dissection complicated by hemopericardium: a case report of another possible cause of coronary malperfusion","volume":"49","author":"Chamnarnphol","year":"2010","journal-title":"Intern Med"},{"key":"2026080311363019600_ivag204-B3","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.jchf.2018.09.009","article-title":"Unloading of the left ventricle during venoarterial extracorporeal membrane oxygenation therapy in cardiogenic shock","volume":"6","author":"Schrage","year":"2018","journal-title":"JACC Heart Fail"},{"key":"2026080311363019600_ivag204-B4","doi-asserted-by":"crossref","first-page":"A27","DOI":"10.1093\/eurheartj\/suab006","article-title":"Left ventricular unloading and the role of ECpella","volume":"23","author":"Belohlavek","year":"2021","journal-title":"Eur Heart J Suppl"},{"key":"2026080311363019600_ivag204-B5","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1002\/ehf2.13512","article-title":"A case series analysis on the clinical experience of Impella 5.5 at a large tertiary care centre","volume":"8","author":"Kennel","year":"2021","journal-title":"ESC Heart Fail"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag204\/69682461\/ivag204.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/8\/ivag204\/69682461\/ivag204.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/8\/ivag204\/69682461\/ivag204.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:36:42Z","timestamp":1785771402000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivag204\/8739084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":5,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,3]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag204","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,21]]},"article-number":"ivag204"}}