Case Report
A previously healthy 61-year-old male was referred to our hospital for
sudden chest pain. Chest computed tomography (CT) revealed ATAAD. We
performed emergency total arch replacement for ATAAD using the elephant
trunk technique under cardiopulmonary bypass and ante-grade selective
cerebral perfusion (Figure 1a and b). The patient was extubated on
postoperative day 1 and started the rehabilitation. However, he
collapsed with right hemiplegia on postoperative day 5. We performed
three-dimensional cerebral CT that revealed occlusion of the left
anterior cerebral artery (Figure 2) . Cerebral thrombectomy was
performed by cerebral interventionalists. Pathology reports revealed a
yellowish material that was collected with the fresh thrombus to be
consistent with BioGlue (Figure 3 a and b).