title: Hybrid approach in an acute type B aortic dissection in a female patient after having a renal transplant.
abstract: This study describes our experiences with a 44-year-old woman who developed acute type B aortic dissection and elected emergency surgery 3 years after a renal transplant. This led to acute ischemia in the right lower extremity. The first stage of surgery was to implant an extra-anatomic (pretracheal) bypass with a GORE-TEX prosthesis from the brachiocephalic trunk to the left common carotid artery. The second stage was implanting a stent graft into the aortic arch that covered the left common carotid artery and the left subclavian artery. The third stage was to insert a stent graft that involved the entire thoracic aorta and proximal segment of the abdominal aorta to the celiac trunk, with the right axillary and left femoral approach. The fourth stage was an extra-anatomic (suprapubic) bypass with the GORE-TEX prosthesis from the left femoral artery to the right femoral artery. Surgery resulted in normal blood supply to the organs and restored renal function.
authors: Department of Clinical Proceedings, Facilty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
authors: Dariusz
authors: D
authors: Janczak
authors: Magdalena
authors: M
authors: Krajewska
authors: Jerzy
authors: J
authors: Garcarek
authors: Jerzy
authors: J
authors: Gancarek
authors: Mariusz
authors: M
authors: Chabowski
mesh_terms: D000208:Acute Disease; D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D011138:Polytetrafluoroethylene