Unexpected intraoperative coronary malperfusion after primary repair of acute type A aortic dissection with surgical glue

In the surgical treatment of acute aortic dissection, the attachment of the dissected wall using surgical glue can be an effective procedure to stabilize the fragile dissected wall. A 42-year-old man underwent aortic root replacement for acute type A aortic dissection. However, after aortic declamping, he experienced severe myocardial impairment, which required an additional procedure of coronary artery bypass grafting. The unexpected myocardial ischaemia can be attributed to the inattentional use of surgical glue.