title: Infradiaphragmatic malperfusion of acute aortic dissection associated with previous abdominal aortic aneurysm repair.
abstract: OBJECTIVE
  To evaluate the association of previous abdominal aortic aneurysm (AAA) graft replacement with infradiaphragmatic malperfusion in patients with acute aortic dissection.
  
  
  METHODS
  Between November 2006 and June 2011, 133 patients were referred to our hospital for management of acute aortic dissection. Eight (6.0 %) of these patients had undergone AAA graft replacement prior to the acute aortic dissection. We compared the computed tomography (CT) images of these 8 patients with those of the remaining 125 patients without previous AAA graft replacement, in terms of organ ischemia as a complication induced by acute aortic dissection.
  
  
  RESULTS
  Infradiaphragmatic malperfusion from acute aortic dissection was confirmed in four of the eight patients who had undergone AAA graft replacement. Contrasted CT scan images indicated that the main cause of infradiaphragmatic malperfusion was collapse of the true lumen from compression by the false lumen into the suprarenal aorta. Although there was no significant difference between the groups in terms of cerebral ischemia and myocardial ischemia, bilateral leg ischemia and visceral ischemia occurred more frequently in the patients who had undergone AAA graft replacement.
  
  
  CONCLUSIONS
  Previous AAA graft replacement is a risk factor for infradiaphragmatic malperfusion in patients with acute aortic dissection.
authors: Department of Thoracic and Cardiovascular Surgery, School of Medicine, Sapporo Medical University, South-1 West-16, Chuo-ku, Sapporo 080-8543, Japan. t.ito@sapmed.ac.jp
authors: Toshiro
authors: T
authors: Ito
authors: Nobuyoshi
authors: N
authors: Kawaharada
authors: Yoshihiko
authors: Y
authors: Kurimoto
authors: Tetsuya
authors: T
authors: Koyanagi
authors: Takeshi
authors: T
authors: Uzuka
authors: Mayuko
authors: M
authors: Uehara
authors: Takayuki
authors: T
authors: Hagiwara
authors: Yohsuke
authors: Y
authors: Yanase
authors: Toshiyuki
authors: T
authors: Maeda
authors: Tetsuya
authors: T
authors: Higami
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000150:complications*; D001014:Aortic Aneurysm / Q000150:complications*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014781:Viscera / Q000098:blood supply*