{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:35:11Z","timestamp":1717634111995},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Pre-operative coronary angiography and concomitant, planned coronary artery bypass are infrequently performed with type A aortic dissection repair. We present a case in which pre-operative coronary computed tomography angiography was appropriate, and subsequent dissection repair and concomitant coronary artery bypass were successfully performed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case Presentation<\/jats:title>\n                <jats:p>The patient is a 58-year-old male with heart failure with preserved ejection fraction, renal insufficiency, hypertension, obesity, and smoking history, who presented with a three-to-four-day history of persistent back pain, worsening exertional dyspnea, and orthopnea, as well as a two-to-three month history of dyspnea, lower extremity edema, and intermittent angina. He was diagnosed with an acute type A aortic dissection and anti-impulse control was initiated. However, repair was delayed in order to allow apixaban to metabolize and decrease the risk of bleeding, as the patient was approximately six days post-dissection, without malperfusion, with a well-controlled blood pressure on anti-impulse therapy, and had received five days of anticoagulation. During this time, coronary computed tomography angiography was performed to assess the need for concomitant revascularization and showed coronary artery disease. Ascending aorta hemiarch replacement with aortic valve resuspension, two-vessel coronary artery bypass grafting, and left atrial appendage clipping were performed successfully.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Pre-operative imaging can be considered in a select group of acute type A aortic dissections that present without malperfusion, and with well-controlled blood pressure on anti-impulse\/negative inotropic therapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-02821-9","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T09:16:19Z","timestamp":1717578979000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed management of acute type A aortic dissection with concomitant coronary artery bypass graft"],"prefix":"10.1186","volume":"19","author":[{"given":"Zohaib R.","family":"Khawaja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuf M.","family":"Aboutabl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel E.","family":"Cambronero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert G.","family":"Willis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron S.","family":"Gilani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartlomiej R.","family":"Imielski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"issue":"7","key":"2821_CR1","first-page":"945","volume":"44","author":"K Zhang","year":"2021","unstructured":"Zhang K, Dong SB, Pan XD, et al. Concomitant coronary artery bypass grafting during surgical repair of acute type a aortic dissection affects operative mortality rather than midterm mortality. AsianJSurg. 2021;44(7):945\u201351.","journal-title":"AsianJSurg"},{"issue":"3","key":"2821_CR2","first-page":"585","volume":"59","author":"LL Creswell","year":"1995","unstructured":"Creswell LL, Kouchoukos NT, Cox JL, Rosenbloom M. Coronary artery disease in patients with type A aortic dissection. TheAnnalsofThoracicSurgery. 1995;59(3):585\u201390.","journal-title":"TheAnnalsofThoracicSurgery"},{"issue":"1","key":"2821_CR3","first-page":"137","volume":"67","author":"AS Jassar","year":"2019","unstructured":"Jassar AS, Sundt TM. How should we manage type a aortic dissection? GenThoracCardiovascSurg. 2019;67(1):137\u201345.","journal-title":"GenThoracCardiovascSurg"},{"issue":"6","key":"2821_CR4","first-page":"694","volume":"38","author":"FJ Criado","year":"2011","unstructured":"Criado FJ. Aortic Dissection TexHeartInstJ. 2011;38(6):694\u2013700.","journal-title":"Aortic Dissection TexHeartInstJ"},{"issue":"11","key":"2821_CR5","first-page":"3827","volume":"37","author":"K Bayamin","year":"2022","unstructured":"Bayamin K, Power A, Chu MWA, Dubois L, Valdis M. Malperfusion syndrome in acute type a aortic dissection: thinking beyond the proximal repair. JournalofCardiacSurgery. 2022;37(11):3827\u201334.","journal-title":"JournalofCardiacSurgery"},{"issue":"10","key":"2821_CR6","first-page":"788","volume":"26","author":"G Deniz","year":"2022","unstructured":"Deniz G, Mola S, \u00c7elikten E, A\u015fk\u0131n G, K\u00fc\u00e7\u00fcker \u015e. Emergency cardiac surgery for Acute Type A aortic dissection on Apixaban. AnatolJCardiol. 2022;26(10):788\u201390.","journal-title":"AnatolJCardiol"},{"issue":"1","key":"2821_CR7","first-page":"171","volume":"16","author":"F Morello","year":"2021","unstructured":"Morello F, Santoro M, Fargion AT, Grifoni S, Nazerian P. Diagnosis and management of acute aortic syndromes in the emergency department. InternEmergMed. 2021;16(1):171\u201381.","journal-title":"InternEmergMed"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02821-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-02821-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02821-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T09:20:29Z","timestamp":1717579229000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-02821-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,5]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2821"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-02821-9","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,5]]},"assertion":[{"value":"2 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"320"}}