Aorto-carotid bypass for cerebral malperfusion after aortic dissection surgery: a case report.
Malperfusion syndrome may complicate the postoperative course in patients who have undergone surgery for aortic dissection. In these cases, open surgery or endovascular intervention may be required. We present a case of postoperative onset of intermittent severe neurological symptoms after surgery for type A aortic dissection. Progressive dissection of the carotid arteries was diagnosed, and treatment options were discussed. A successful aorto-carotid bypass was performed by cardiac and vascular surgeons in collaboration. All neurological symptoms were completely resolved. We advocate a high degree of vigilance for signs of cerebral malperfusion in the intensive care unit. Early intervention can result in a successful outcome, as illustrated by this case report.
Sartipy
Ulrik
U
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. Ulrik.Sartipy@karolinska.se
Malmstedt
Jonas
J
Holm
Peter
P
Owall
Anders
A
Dellgren
Göran
G
D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D002339:Carotid Arteries / Q000601:surgery; D002548:Cerebral Revascularization / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods*