title: Delayed Intestinal Ischemia after Surgery for Type A Acute Aortic Dissection.
abstract: We report a rare case of delayed intestinal ischemia after total arch replacement for type A acute aortic dissection. At the onset of acute aortic dissection, computed tomography (CT) angiography revealed celiac trunk occlusion and progressive dissection into the superior mesenteric artery without stenosis. However, following total arch replacement, visceral malperfusion was not detected by exploratory laparotomy. On postoperative day 12, the patient developed paralytic ileus without an elevated lactate level. CT angiography revealed new superior mesenteric artery stenosis by a thrombosed false lumen with persistent celiac trunk occlusion. Endovascular treatment including stent implantation resolved intestinal ischemia.
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Osaka, Japan.
authors.forename: Akimasa
authors.initials: A
authors.lastname: Morisaki
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kato
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Osaka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Motoki
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Osaka, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Osaka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Osaka, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shibata
keywords: aortic dissection; endovascular treatment; intestinal ischemia