Type‐A acute aortic dissection complicated by parenchymal hemorrhagic stroke: Timing of surgery for a rare presentation of aortic dissection

Abstract

Acute type‐A aortic dissection is a rare but life‐threatening cardiac surgery emergency. Immediate operative management is important to give patients the best chance of survival. However, where an aortic dissection is complicated by a concurrent hemorrhagic stroke the risks of precipitating a catastrophic intracranial hemorrhage during surgery must be balanced against the risk of aortic rupture. The optimal timing of surgery in this rare presentation of type‐A aortic dissection is unknown. In this case report we describe a 67‐year‐old gentleman who initially presented with neurological symptoms, and was diagnosed with an acute intracerebral hemorrhage, but was subsequently also diagnosed with an acute type‐A aortic dissection. He proceeded to have a successful tissue aortic root replacement, total arch replacement with zone two frozen elephant trunk implantation 4 weeks after his initial diagnosis.