Endovascular Repair Prior to Total Aortic Arch Replacement for Stanford A Acute Aortic Dissection with Abdominal Organ Ischemia

Yoshiki Endo, Yoshihito Irie, Tsuyoshi Fujimiya, Akinobu Kitagawa
2019 Japanese Journal of Cardiovascular Surgery  
A 47-year-old man was admitted to our hospital complaining of chest and back pain. Enhanced CT scan revealed Stanford type A acute aortic dissection. The celiac artery CA was not enhanced and the superior mesenteric artery SMA appeared on the delayed phase. There was a small amount of pericardial effusion. Blood gas analysis showed metabolic acidosis. To treat mesenteric malperfusion, we initially performed thoracic endovascular aortic repair TEVAR by the PETTICOAT technique and stenting to CA
more » ... nd SMA. The acidosis gradually normalized after TEVAR. We then performed surgical central repair total arch replacement . He temporarily showed paraplegia after the operation but soon recovered by treatment for spinal ischemia. He was discharged 68 days post operatively without any
doi:10.4326/jjcvs.48.138 fatcat:ivp22emzdffqfpzpbl5jogwgaq