Severe stenosis of the true lumen in the abdominal aorta after an ascending aorta reconstruction for an acute type a dissection: report of a case.
We encountered a case of severe symptomatic stenosis of the abdominal aorta after a surgical repair of an ascending aortic dissection. A 75-year-old woman underwent a reconstruction of the ascending aorta to treat a Stanford type A acute aortic dissection and cardiac tamponade. Eight hours postoperatively, the patient was anuric. An abdominal computed tomography scan revealed severe stenosis of the true lumen of the suprarenal abdominal aorta due to a dilatation of the false lumen. The patient's ischemic symptoms progressed to include a weakening femoral pulse and, as a result, an emergency right axillofemoral artery bypass was performed. We hypothesize that the stenosis of the true lumen of the abdominal aorta was secondary to the mechanical obstruction due to a false lumen, which already existed because of the thoracic dissection, and its size increased postoperatively as a consequence of uncontrolled postoperative hypertension.
Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Chuodori, Morioka, Japan.
Hajime
H
Kin
Tatsuya
T
Sasaki
Takayuki
T
Nakajima
Hiroshi
H
Izumoto
Masayuki
M
Mukaida
Kunihiro
K
Yoshioka
Kohei
K
Kawazoe
D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001012:Aorta, Abdominal / Q000473:pathology*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed