| Acute aortic occlusion due to false-lumen expansion after repair of abdominal aortic rupture in type B acute aortic dissection. | |
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MedLine Citation:
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PMID: 20471797 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We describe a patient with aortic occlusion due to false-lumen expansion after repair of abdominal aortic rupture in acute type B aortic dissection. A 70-year-old man presented to a nearby hospital with severe lower back pain, and was subsequently referred to our hospital with a diagnosis of abdominal aortic rupture. Computed tomography scanning on admission revealed type B aortic dissection with concomitant false-lumen rupture at the level of pre-existing infrarenal abdominal aortic aneurysm. The patient underwent abdominal aortic replacement with the true lumen reconstructed using a bifurcated knitted Dacron graft. On postoperative day 2, the patient developed severe lower body ischemia. Computed tomography scanning revealed complete true-lumen occlusion at the renal artery level because of false-lumen expansion. The patient underwent open fenestration by opening the bulging flap with a transverse graftotomy distal to the proximal graft anastomosis. After fenestration, the patient developed severe metabolic complications (i.e., myonephropathic-metabolic syndrome) and died a day later of cardiac arrest resulting from hyperkalemia. Abdominal aortic replacement with true-lumen reconstruction in patients with abdominal aortic rupture in type B acute aortic dissection could also lead to acute aortic occlusion due to re-dissection or true-lumen compromise accompanying retrograde propagation of false-lumen thrombosis. This lethal sequela after true-lumen reconstruction might be prevented by an adjuvant procedure such as concomitant fenestration. |
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Authors:
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Hiroshi Yamamoto; Fumio Yamamoto; Hiroshi Izumoto; Keisuke Shiroto; Fuminobu Tanaka; Gembu Yamaura; Mamika Motokawa; Kazuyuki Ishibashi |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-05-14 |
Journal Detail:
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Title: Annals of vascular surgery Volume: 24 ISSN: 1615-5947 ISO Abbreviation: Ann Vasc Surg Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-13 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 951.e1-6 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiovascular Surgery, Akita University School of Medicine, Akita, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Accidents, Traffic Acute Disease Aged Aneurysm, Dissecting / complications, radiography, surgery* Aortic Aneurysm, Abdominal / complications, radiography, surgery* Aortic Diseases / etiology*, radiography, surgery Aortic Rupture / etiology, radiography, surgery* Aortography / methods Arterial Occlusive Diseases / etiology*, radiography, surgery Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation / adverse effects*, instrumentation Fatal Outcome Hematoma / etiology, surgery Humans Male Polyethylene Terephthalates Prosthesis Design Reoperation Tomography, X-Ray Computed Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Polyethylene Terephthalates |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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