Delayed onset of amaurosis fugax in a patient with type A aortic dissection post surgical repair.

Stroke is an important complication for the surgical treatment of type A aortic dissection and it occurs immediately post operation. Many surgical techniques such as deep hypothermic circulatory arrest and retrograde cerebral perfusion have been reported to ameliorate this complication. We report here a male Taiwanese patient with type A aortic dissection involving the arch who underwent surgical repair. Amaurosis fugax appeared on the 4th day post operation. Funduscopic findings demonstrated multi focal embolization and carotid sonography revealed normal carotid arteries. The symptoms and signs improved after anticoagulation therapy. This is a rare case of delayed onset of amaurosis fugax in a patient with type A aortic dissection post surgical repair. The thromboemboli might have originated from the internal surface of the sawing area.