Consequences of incomplete repair of acute type A aortic dissection.
During emergency repair of acute Stanford type A aortic dissections, surgical compromises in the form of incomplete arch replacement are made due to the unstable condition of the patient and safety issues of the performing team. We report a case of delayed reoperation after previous incomplete surgery for acute type A aortic dissection in a young patient with Marfan's syndrome. He presented again with repetitive chest pain five years after initial surgical treatment. Extensive aneurysmal dilatation of the aorta and remaining dissection led to the decision to replace the ascending aorta and the aortic arch. After a good progress during the first days after surgery, the patient died due to a ruptured thoraco-abdominal aneurysm on the fifth postoperative day. Extensive surgical reconstruction including aortic arch replacement should be considered in patients with Marfan's syndrome who present with aortic dissections type A to avoid unnecessary reoperations and their complications.
Sorokin
Vitaly Aleksandrovich
VA
Department of Cardiac, National University Hospital, National University of Singapore, Singapore.
Kofidis
Theo
T
Woitek
Felix
F
Martinez
Eliana Cecilia
EC
Lee
Chuen Neng
CN
Klima
Uwe
U
D000208:Acute Disease; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D004108:Dilatation, Pathologic; D004638:Emergency Treatment; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult