[A successful repair of the aortic dissection (DeBakey type I) with ischemic complications of the kidney and lower extremities].
A 65-year-old male was referred to our institution under diagnosis of aortic dissection which passed 1 month after the onset. An aortography revealed DeBakey type I aortic dissection with the left renal artery involvement and the very narrow true lumen of the abdominal aorta compressed by the pseudolumen, especially at the orifice of the right renal artery. On the 3rd day of admission, the patient manifested SVC syndrome, oliglia and pulselessness of the femoral artery bilaterally, that indicated ischemia of the kidney and the lower extremities. An emergency operation was performed, and the ascending aorta was replaced using open distal anastomotic technique for the distal site of the aorta under deep hypothermia and retrograde cerebral perfusion method. The ischemic symptoms and SVC syndrome were disappeared promptly after operation. Postoperative CTscan showed the narrow true lumen of the abdominal aorta expanded remarkably. The postoperative course was uneventful and the patient discharged on the 54th postoperative day.
Uwabe
K
K
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Hashimoto
A
A
Aomi
S
S
Takazawa
A
A
Imamaki
M
M
Noji
S
S
Niinami
H
H
Uesugi
H
H
Kunii
Y
Y
Saito
N
N
D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000601:surgery; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications* / Q000601:surgery; D001807:Blood Vessel Prosthesis; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D007668:Kidney / Q000098:blood supply*; D007866:Leg / Q000098:blood supply*; D008297:Male; D013479:Superior Vena Cava Syndrome / Q000209:etiology*