Emergent repair of a complex dissecting aneurysm in the thoracic aorta

Efrem Civilini, Luca Bertoglio, Daniele Mascia, Michele De Bonis, Roberto Chiesa

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)687-691
Number of pages5
JournalTexas Heart Institute Journal
Volume39
Issue number5
Publication statusPublished - 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

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