# Case Report: Surgery combined with extracorporeal membraneoxygenation for acute type A aortic dissection complicated with acute myocardial infarction

## TL;DR

This case report describes successful treatment of three patients with aortic dissection and heart attack using combined surgery and ECMO support.

## Contribution

The paper presents a novel one-stage surgical approach combined with ECMO for treating ATAAD with AMI.

## Key findings

- One-stage surgery with ECMO support improved outcomes in patients with ATAAD and AMI.
- All three patients recovered well and were discharged after treatment.
- ECMO was effectively used as a bridge during surgery to stabilize hemodynamics.

## Abstract

Acute myocardial infarction (AMI) is one of the most serious complications of acute type A aortic dissection (ATAAD) and markedly increases patient mortality. Simultaneous treatment strategies remain controversial. How to improve the treatment of these patients remains a critical challenge for cardiovascular surgeons.

All three patients who experienced chest pain were admitted to emergency department of our hospital. The 12-lead electrocardiogram revealed ST-segment depression, myocardial enzyme levels were significantly elevated. Emergency physicians diagnosed ATAAD with AMI, and emergency surgery was planned in collaboration with the cardiovascular surgery team. One-stage surgery for coronary revascularization and central aortic repair were performed, extracorporeal membrane oxygenation (ECMO) was implanted, ECMO was discontinued when hemodynamics stabilized. The patient ultimately recovered well and was discharged.

For ATAAD combined with right ventricular AMI, one-stage surgery for coronary revascularization and central aortic repair, supported by ECMO as bridge, can be life-saving treatment strategy, the prognosis for all three patients was excellent.