Abstract
Endovascular treatment of complex thoracic pathologic conditions involving the aortic arch can often be appropriate and safe; however, minimally invasive procedures are not always feasible, especially in emergent cases. We report the case of a 78-year-old woman who emergently presented in hemorrhagic shock with a ruptured chronic dissecting aneurysm that involved the aortic arch. Eight years earlier, she had undergone aortic valve replacement and plication of the ascending aorta, which was complicated a day later by Stanford type B dissection, malperfusion, and ischemia that required an axillobifemoral bypass. At the current admission, we successfully treated her surgically through a left thoracotomy, using moderate hypothermic extracorporeal circulation and advanced organ-protection methods. We discuss the surgical indications and our operative strategy in relation to open surgical repair versus endovascular treatment in patients with complex conditions.
Original language | English |
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Pages (from-to) | 687-691 |
Number of pages | 5 |
Journal | Texas Heart Institute Journal |
Volume | 39 |
Issue number | 5 |
Publication status | Published - Oct 2012 |
Keywords
- Aneurysm, dissecting/radiography/surgery
- Aortic aneurysm, thoracic/radiography/surgery
- Aortic diseases/surgery
- Aortic rupture/surgery
- Treatment outcome
- Vascular surgical procedures
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine