| Successful Surgical Treatment
of Ruptured Abdominal Aortic Aneurysm Following Stanford Type
B Acute Aortic Dissection |
(Department of Cardiovascular Surgery, Saiseikai-Shimonoseki
General Hospital, Shimonoseki, Japan)
| Toshiro Kobayashi |
Kensuke Sakata |
Kenji Hayashi |
| Yurio Kobayashi |
|
|
|
A 72-year-old man presented with
back pain and 3 days after admission, chest and abdominal CT
scanning revealed the existence of infrarenal abdominal aortic
aneurysm with Stanford type B acute aortic dissection and hemorrhage
in the retroperitoneal space. The maximum diameter of the abdominal
aortic aneurysm was 60mm. After treating with anti-hypertensive
therapy under restrictive observation because of the patient's
stable general condition, surgery was performed 45days after
admission. The dissection extended into the abdominal aortic
aneurysm and all visceral arteries branched from the true lumen.
The presence of thrombus in the preperitoneal space suggested
a ruptured abdominal aortic aneurysm. Abdominal aortic aneurysm
was replaced with a Y shaped graft and proximal anastomoses was
performed with fenestration to prevent rupture of the proximal
dissecting aorta. We report a rare case of ruptured abdominal
aortic aneurysm following Stanford type B acute aortic dissection,
which was operated on in the chronic stage. The patient is doing
well.
Jpn. J. Cardiovasc. Surg. 33: 220-223 (2004) |
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