Recovery from Out-of-Hospital Cardiopulmonary Arrest Due to Type A Acute Aortic Dissection: A Case Report

Abstract

Case: A 55-year-old man without past medical histories suffering from back pain for two weeks was successfully resuscitated from an 8-min cardiopulmonary arrest (CPA) and was brought to our hospital by ambulance. Computed tomography demonstrated type A acute aortic dissection (AAAD) with brachiocephalic artery occlusion. After admission, Glasgow Coma Scale score improved to E1VTM4, and voluntary movement was noted only in the right limbs. Outcome: The patient underwent emergency grafting of the ascending aorta and innominate artery under deep hypothermic circulatory arrest. After surgery, the patient recovered with mild disorientation and left hemiplegia. Magnetic resonance imaging of the head revealed no large infarction but revealed multiple acute ischemic changes. One year later, the patient demonstrated independent walk and successfully returned to work life. Conclusions: Immediate resuscitation and surgery resulted in good recovery from CPA after AAAD.

Thoracic Endovascular Aortic Repair for Cardiopulmonary Arrest Due to Aortic Dissection

“…The patient recovered from cardiac arrest due to TAAD by TEVAR, generally assuming poor prognosis. A few cases of recovery from TAAD leading to CPA were reported [2]. The initial rhythm of the patient was considered as a key point for recovery.…”

“…Case Reports in Clinical Medicine, 10, 387-392. https://doi.org/10.4236/crcm.2021.1011048 cardiopulmonary arrest (CPA) are few, with a very poor prognosis [1]. Especially for the treatment of CPA due to TAAD, a fatal or unfavorable outcome is associated with CPA, coma, and stroke; therefore, surgery may not be performed from presuming poor prognosis [2]. However, some patients achieve good outcomes with surgery, even after the occurrence of CPA preoperatively [3].…”