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 |
|---|---|
| Pages (from-to) | 687-691 |
| Number of pages | 5 |
| Journal | Texas Heart Institute Journal |
| Volume | 39 |
| Issue number | 5 |
| Publication status | Published - Oct 2012 |
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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
Cite this
Emergent repair of a complex dissecting aneurysm in the thoracic aorta. / Civilini, Efrem; Bertoglio, Luca; Mascia, Daniele; De Bonis, Michele; Chiesa, Roberto.
In: Texas Heart Institute Journal, Vol. 39, No. 5, 10.2012, p. 687-691.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Emergent repair of a complex dissecting aneurysm in the thoracic aorta
AU - Civilini, Efrem
AU - Bertoglio, Luca
AU - Mascia, Daniele
AU - De Bonis, Michele
AU - Chiesa, Roberto
PY - 2012/10
Y1 - 2012/10
N2 - 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.
AB - 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.
KW - Aneurysm, dissecting/radiography/surgery
KW - Aortic aneurysm, thoracic/radiography/surgery
KW - Aortic diseases/surgery
KW - Aortic rupture/surgery
KW - Treatment outcome
KW - Vascular surgical procedures
UR - http://www.scopus.com/inward/record.url?scp=84870168923&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84870168923&partnerID=8YFLogxK
M3 - Article
C2 - 23109769
AN - SCOPUS:84870168923
VL - 39
SP - 687
EP - 691
JO - Texas Heart Institute Journal
JF - Texas Heart Institute Journal
SN - 0730-2347
IS - 5
ER -