Document Detail

Dynamic aortic obstruction in a patient with acute type B dissection.
MedLine Citation:
PMID:  16628024     Owner:  NLM     Status:  MEDLINE    
There are at least 7000 aortic dissections diagnosed in the United States each year. Type B dissections accounted for 38% of cases enrolled in the prospective International Registry of Aortic Dissection. We report a case of a 48-year-old hypertensive woman with an acute type B aortic dissection causing significant dynamic obstruction of the aorta. Intravascular ultrasound of her aorta revealed a mobile intimal flap nearly obliterating the true lumen with each systolic contraction. Simultaneous pressure tracings obtained from her ascending aorta and femoral artery demonstrated a systolic pressure gradient in excess of 100 mm Hg. The patient developed progressive renal failure and ultimately underwent successful operative replacement of the proximal descending thoracic aorta with a Dacron graft. In this case presentation, we highlight the unusual physiology exemplified by this case and explore contemporary management strategies for complicated type B aortic dissection, including surgery and catheter-based techniques.
Jessica L Mega; Alexander R Opotowsky; Zelmira Curillova; Patrick T O'Gara
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cardiology in review     Volume:  14     ISSN:  1061-5377     ISO Abbreviation:  Cardiol Rev     Publication Date:    2006 May-Jun
Date Detail:
Created Date:  2006-04-21     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-4     Citation Subset:  IM    
Brigham and Women's Hospital, Boston, Massachusetts, USA.
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MeSH Terms
Aneurysm, Dissecting / complications*,  diagnosis*,  physiopathology,  surgery
Aortic Aneurysm, Thoracic / complications*,  diagnosis*,  physiopathology,  surgery
Aortic Valve Stenosis / diagnosis,  etiology*,  physiopathology,  surgery
Blood Vessel Prosthesis Implantation
Mesenteric Artery, Superior / pathology,  radiography,  surgery,  ultrasonography
Middle Aged
Subclavian Artery / pathology,  radiography,  surgery,  ultrasonography

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