| A Surgical Case of Acute Aortic
Dissection with Antiphospholipid Syndrome |
(The Second Department of Surgery, Shinshu University
School of Medicine, Matsumoto, Japan)
| Tsuneo Nakajima |
Hiroto Kitahara |
Tetsuya Kono |
| Keizo Ohta |
Tamaki Takano |
Ryo Hasegasa |
| Hirohisa Goto |
Hirofumi Nakano |
Hideo Kuroda |
| Jun Amano |
|
|
|
The patient was a 52-year-old man
with a history of antiphospholipid syndrome (APS), renal dysfunction
and myasthenia gravis(MG). On May 2, 1998, he had sudden chest
pain while sleeping. Enhanced computed tomography revealed acute
aortic dissection (DeBakey type I). We performed emergency graft
replacement of the ascending aorta and the aortic arch under
extracorporeal circulation. Because of perioperative anuria,
we used peritoneal dialysis (PD) just after the operation. Two
days after the operation, we performed re-intubation nine hours
after the extubation of the tracheal tube, and performed re-extubation
three days later. For a while, his postoperative course was uneventful,
but because of gradual worsening of APS, we administered more
prednisolone, but 74 days after the operation, he died of multiple
organ failure caused by an opportunistic infection, sepsis, and
disseminated intravascular coagulation. This was very rare case
of acute aortic dissection with MG and APS. After administration
of more glucocorticoids, it is important to be wary of opportunistic
infections.
Jpn. J. Cardiovasc.Surg. 30: 311-313(2001) |
|
