Nonocclusive Mesenteric Ischemia That Developed during Redo-double Valve Replacement Surgery, and This Was Caused by Acute Aortic Dissection

이중판막 재치환술 시 발생한 급성 대동맥 박리증으로 인한 비폐쇄성 장간막 허혈

  • Lee, Sak (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Song, Suk-Won (Department of Thoracic and Cardiovascular Surgery, Kangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Cho, Sang-Ho (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Song, Seung-Jun (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Kwan-Wook (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Chang, Byung-Chul (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine)
  • 이삭 (연세대학교 의과대학 세브란스병원 흉부외과학교실) ;
  • 송석원 (연세대학교 의과대학 강남세브란스병원 흉부외과학교실) ;
  • 조상호 (연세대학교 의과대학 세브란스병원 흉부외과학교실) ;
  • 송승준 (연세대학교 의과대학 세브란스병원 흉부외과학교실) ;
  • 김관욱 (연세대학교 의과대학 세브란스병원 흉부외과학교실) ;
  • 장병철 (연세대학교 의과대학 세브란스병원 흉부외과학교실)
  • Published : 2009.04.05

Abstract

Nonocclusive mesenteric ischemia (NOMI) is a rare complication that occurs in about 0.05% of patients after openheart surgery, and NOMI refers to the mesenteric ischemia that's caused by splanchnic vasospasm without occlusion of the great intestinal vessels. In the presently reported case, NOMI developed to maintain the blood flow to the heart and brain after several minutes of a hypotensive status and the latter was caused by acute aortic dissection that complicated an aortic cannulation procedure. Unfortunately, the patient died even though the problems were diagnosed early and proper treatment was administered. Early diagnosis of NOMI by angiography and the selective infusion of vasodilators are thought to be the only way to improve survival for patients with clinically suspected NOMI.

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