{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:54:19Z","timestamp":1753890859932,"version":"3.41.2"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>A 74-year-old female was found hemiplegic in a public restroom. After arrival in our stroke unit, a computed tomography (CT) was performed, and she was diagnosed with bilateral carotid artery and right vertebral artery occlusion due to an acute type A aortic dissection. The patient deteriorated quickly to a GCS of 3 and was brought to the operating room, where a salvage replacement of the ascending aorta and the proximal aortic arch was performed with unilateral antegrade cerebral perfusion. Three days later, a significant decrease in left ventricular function and increase in cardiac biomarkers were observed. Coronary CT displayed residual dissection of the aortic root, extending into the left main coronary artery. The patient underwent an intravascular ultrasound-guided stenting of the left main, resulting in total recovery of heart function. She was extubated on the fourth postoperative day, with no residual neurological impairment. This case report advocates for the proper management of patients with ATAAD with severe neurological impairment, emphasizing the importance of a robust multidisciplinary approach in their care.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1516152","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T13:26:32Z","timestamp":1738848392000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: PCI of the left coronary artery after salvage operation in a comatose patient with an acute type A aortic dissection"],"prefix":"10.3389","volume":"12","author":[{"given":"Jan","family":"Bidovec","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petar","family":"Risteski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara E.","family":"St\u00e4hli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Dzemali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Hofmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Stehli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1093\/icvts\/ivz311","article-title":"Preoperative neurological deficit in acute type A aortic dissection","volume":"30","author":"Kreibich","year":"2020","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S213","DOI":"10.1016\/j.jtcvs.2012.11.054","article-title":"Patients with type A acute aortic dissection presenting with major brain injury: should we operate on them?","volume":"145","author":"Di Eusanio","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3390\/jpm13010058","article-title":"Stenting in brain hemodynamic injury of carotid origin caused by type A aortic dissection: local experience and systematic literature review","volume":"13","author":"Aita","year":"2022","journal-title":"J Pers Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.athoracsur.2004.01.038","article-title":"Surgical results of acute aortic dissection complicated with cerebral malperfusion","volume":"80","author":"Tanaka","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.athoracsur.2020.08.046","article-title":"Type A aortic dissection with cerebral malperfusion: new insights","volume":"112","author":"Fukuhara","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S163","DOI":"10.1161\/CIRCULATIONAHA.110.011551","article-title":"Neurological outcomes after immediate aortic repair for acute type A aortic dissection complicated by coma","volume":"124","author":"Tsukube","year":"2011","journal-title":"Circulation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1510\/icvts.2009.228908","article-title":"Recovery of severe neurological dysfunction after restoration of cerebral blood flow in acute aortic dissection","volume":"10","author":"Pocar","year":"2010","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1016\/j.athoracsur.2005.09.076","article-title":"Coma might not preclude emergency operation in acute aortic dissection","volume":"81","author":"Pocar","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1093\/icvts\/ivaa092","article-title":"Aorto-carotid bypass for type A acute aortic dissection complicated with carotid artery occlusion: no touch until circulatory arrest","volume":"31","author":"Sasaki","year":"2020","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/S0022-5223(94)70269-1","article-title":"Rapid noninvasive diagnosis and surgical repair of acute ascending aortic dissection. 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