title: [Emergency surgical salvage for a closing aortic dissection: 2 case reports].
abstract: We report here the emergency surgical salvage for closing an aortic dissection in 2 female patients (case 1; 52 years old, case 2; 72 year old). They were admitted to our clinic for severe back pain (case 1) and a loss of consciousness (case 2). Acute aortic dissection (Stanford A type) with cardiac tamponade was confirmed by chest CT, aortography, and cardiac ultrasonography. Diagnosis was determined as a closing aortic dissection from a thrombosed pseudolumen on enhanced chest CT. An emergency operation was performed on the ascending aorta replacement and included resection of the entry port. The postoperative courses were uneventful, except for temporary hemodialysis in case 1. A closing aortic dissection is a new subcategory for an acute aortic dissection. Diagnosis is difficult, but it is regarded as having a good prognosis following timely emergency treatment. However, provided there is no complication, we recommend that surgical treatment should be performed aggressively to avoid rupture and/or cardiac tamponade.
authors.affiliation: Department of Cardiovascular Surgery, Koga Hospital, Kurume, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Y
authors.initials: Y
authors.lastname: Okazaki
authors.forename: K
authors.initials: K
authors.lastname: Doi
authors.forename: H
authors.initials: H
authors.lastname: Suda
authors.forename: M
authors.initials: M
authors.lastname: Yoshikai
authors.forename: T
authors.initials: T
authors.lastname: Itoh
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002305:Cardiac Tamponade / Q000209:etiology; D004630:Emergencies; D005260:Female; D006801:Humans; D008875:Middle Aged