Abstract
BackgroundAcute aortic dissection (AAD) is a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A AAD (TAAAD) still remains high, and treatment for such patients remains controversial. We report a successful treatment of TAAAD with a communicating false lumen in a 60-year-old man with acute hemi-cerebral malperfusion.Case presentationThe ascending aorta was wrapped with stepwise external wrapping (SEW) procedure, and subsequent thoracic endovascular aortic repair (TEVAR) was successfully performed. The patient was discharged in good physical condition without any complications.ConclusionsHybrid therapy with SEW and TEVAR with TAAAD associated with major cerebral malperfusion should be considered, especially in patients for whom open surgery is extremely risky.
Highlights
We report a successful less-invasive hybrid therapy of type A acute aortic dissection (TAAAD) in a 60year-old man with acute hemi-cerebral malperfusion.Case presentation The patient was a 60-year-old man with a medical history of untreated severe sleep apnea syndrome, hypertension, and paroxysmal atrial fibrillation without any medication because of low compliance
Hybrid therapy with stepwise external wrapping (SEW) and thoracic endovascular aortic repair (TEVAR) with Type A AAD (TAAAD) associated with major cerebral malperfusion should be considered, especially in patients for whom open surgery is extremely risky
Comments To the best of our knowledge, this is the first reported case in the literature of successful “hybrid” therapy with SEW and TEVAR for a TAAAD associated with major cerebral malperfusion
Summary
We report a successful less-invasive hybrid therapy of type A acute aortic dissection (TAAAD) in a 60year-old man with acute hemi-cerebral malperfusion.Case presentation The patient was a 60-year-old man with a medical history of untreated severe sleep apnea syndrome, hypertension, and paroxysmal atrial fibrillation without any medication because of low compliance. Introduction We report a successful less-invasive hybrid therapy of type A acute aortic dissection (TAAAD) in a 60year-old man with acute hemi-cerebral malperfusion. * Correspondence: suematus@tf7.so-net.ne.jp Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299 Kaname, Tsukuba, Ibaraki 300-2622, Japan absence of perfusion to right whole cerebral artery without any irreversible brain damage and TAAAD with a 20 mm of intimal tear in the descending aorta, and obvious cardiac tamponade (Fig. 1a-d).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
