| A Surgically Treated Case of
Stanford Type B Acute Aortic Dissection Extending through Atherosclerotic
Abdominal Aortic Aneurysm |
(Department of Cardiovascular Surgery, University
Hospital of Tsukuba, Tsukuba, Japan and Department of Surgery,
Institute of Clinical Medicine, University of Tsukuba*, Tsukuba,
Japan)
| Hiroko Nakata |
Tomoaki Jikuya* |
Motoo Osaka |
| Toshio Mitsui* |
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|
A 72-year-old man presented with
chief complaints of back pain. Medical workup discovered infrarenal
abdominal aortic aneurysm (AAA) with Stanford type B acute aortic
dissection on CT. The dissection originated distal to the left
subclavian artery and extended to the right commom iliac artery.
All visceral arteries branched from the false lumen. The maximum
diameter of the thoracic aneurysm was 4.8 cm and that of the
abdominal aneurysm was 6.5 cm. Multiple renal infarcts were noted
and the right kidney function was decreased. Initial surgery
was performed 3 months after presentation using a graft technique.
Advanced atherosclerosis and dissection were noted in the aneurysm
making the arterial wall quite vulnerable. Hemorrhage was extensive
and hemostasis difficult in the defective arterial wall. The
patient became unstable so the aneurysm was closed and the surgical
procedure was changed to right axillo-bifemoral bypass rather
than the original surgical plan of anatomic reconstruction of
the AAA. The patient tolerated the procedure well. We report
a rare case of acute aortic dissection which extended through
the AAA.
Jpn. J. Cardiovasc. Surg. 31：350-352 (2002) |
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