title: Aorto-carotid bypass for cerebral malperfusion after aortic dissection surgery: a case report.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. Ulrik.Sartipy@karolinska.se
authors.forename: Ulrik
authors.initials: U
authors.lastname: Sartipy
authors.forename: Jonas
authors.initials: J
authors.lastname: Malmstedt
authors.forename: Peter
authors.initials: P
authors.lastname: Holm
authors.forename: Anders
authors.initials: A
authors.lastname: Owall
authors.forename: Göran
authors.initials: G
authors.lastname: Dellgren
mesh_terms: 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*