scholarly journals 1. Hybrid approach to repair type A aortic dissection: Combined endovascular superior mesenteric artery stenting and Bental procedure

2015 ◽  
Vol 27 (4) ◽  
pp. 299 ◽  
Author(s):  
Hamoud Yahya Obied ◽  
Ayman Ghoneim ◽  
Mohamed F. Ibrahim
2021 ◽  
Vol 9 ◽  
pp. 2050313X2110211
Author(s):  
Roxana Carmen Geana ◽  
Platon Pavel ◽  
Reza Nayyerani ◽  
Iulia Kulcsar ◽  
Adrian Tulin ◽  
...  

Here, we describe a case of a 61-year-old male patient with acute type A aortic dissection involving the ascending aorta, aortic arch, descending aorta, and the abdominal aorta down to the iliac bifurcation with evidence of left common iliac artery occlusion. Computed tomography angiography revealed progressive dissection into the superior mesenteric artery and left renal artery with no clinical signs of mesenteric ischemia. Emergent ascending aortic reconstruction of the dissected aorta relieves the leg ischemia. On a postoperative day 9, the evolution was complicated by massive right hemothorax. Although the patient was hemodynamically stable after obtaining hemostasis, the patient developed paralytic ileus with a high elevated lactate level. Visceral malperfusion was not detected by exploratory laparotomy. Emergency abdominal aortic angiography revealed superior mesenteric artery intermittent occlusion, successfully treated by stenting implantation.


2020 ◽  
Vol 35 (12) ◽  
pp. 3581-3584
Author(s):  
Sho Kusadokoro ◽  
Naoyuki Kimura ◽  
Kosuke Miyoshi ◽  
Daijiro Hori ◽  
Manabu Shiraishi ◽  
...  

Author(s):  
Puja Gaur ◽  
Karthikeshwar Kasirajan ◽  
Daniel L. Miller ◽  
Thomas A. Vassiliades

Long-term management after repair of a type A aortic dissection includes aggressive medical therapy and routine surveillance with serial imaging to ensure thrombosis of the false lumen. Retained patency of the false lumen can lead to either the development of a false lumen aneurysm with a subsequent rupture or extension of dissection. Typically such events occur late, usually months after repair, and are treated with either a conventional one-stage open thoracoabdominal repair or a two-stage “elephant trunk” procedure. However, most patients who undergo such procedures experience major complications and the procedure-related mortality rate is high. We present a unique case of a 61-year-old woman who presented with a ruptured type B aortic dissection 3 weeks after repair of a type A aortic dissection. She underwent an emergent thoracotomy and primary repair of the ruptured aorta followed by concomitant arch debranching and thoracic stent graft placement. Simultaneous surgical debranching with a median sternotomy and endovascular repair with stent grafts is an attractive hybrid approach in patients who present with an acute rupture of a false lumen aneurysm soon after initial repair of an aortic dissection, a situation in which a conventional repair is not feasible. This report emphasizes that hybrid thoracic stent graft repair should be considered for such high-risk patients in the near future as it offers them relatively lower morbidity and mortality compared with what is seen with conventional repairs.


2014 ◽  
Vol 64 (7) ◽  
pp. 422-424 ◽  
Author(s):  
Wataru Kato ◽  
Takashi Fujita ◽  
Kenichiro Uchida ◽  
Hisaaki Munakata ◽  
Makoto Hibino ◽  
...  

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