Novel approach to the treatment of distal malperfusion secondary to ascending aortic dissection.
Acute Type A dissection is a surgical emergency. The presence of visceral and extremity malperfusion syndromes increases perioperative mortality twofold. On occasion, significant malperfusion may best be addressed in a staged fashion with preliminary attention to specific vascular beds with delayed repair of the dissection itself. We present a subacute Type A dissection associated with malperfusion of multiple vascular beds (mesenteric, renal, and iliofemoral) managed with a complication-specific approach utilizing endovascular thoracoabdominal aortic repair prior to ascending repair.
Division of Thoracic and Cardiovascular Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Cyrus J
CJ
Parsa
Richard L
RL
McCann
G Chad
GC
Hughes
D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D004452:Echocardiography; D005121:Extremities / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015607:Stents; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods; D014781:Viscera / Q000098:blood supply*