title: Intraoperative endotoxin adsorption for visceral malperfusion complicating acute type A aortic dissection.
abstract: A 65-year-old man presenting with visceral malperfusion complicating acute type A aortic dissection underwent emergent surgery. Bypass grafting from the right common iliac artery to the superior mesenteric artery was performed prior to central aortic repair because intestinal ischemia caused hemodynamic instability. Subsequently, the ascending aorta was replaced with a Dacron graft under a condition of circulatory arrest with selective cerebral perfusion. Endotoxin adsorption was carried out intraoperatively in parallel with cardiopulmonary bypass to prevent postoperative end-organ failure. The patient recovered uneventfully and was discharged from our hospital 31 days after surgery.
authors.affiliation: Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, 2-1-10 Marunouchi, Kita-ku, Okayama, 700-0823, Japan. toshinoritotsugawa@mac.com
authors.forename: Toshinori
authors.initials: T
authors.lastname: Totsugawa
authors.forename: Masamichi
authors.initials: M
authors.lastname: Ozawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kuinose
authors.forename: Satoko
authors.initials: S
authors.lastname: Ishii
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yoshitaka
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tamaki
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D004731:Endotoxins / Q000097:blood*; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply*; D007430:Intraoperative Care; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011112:Polymyxin B / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004731:Endotoxins; D011112:Polymyxin B