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J Thorac Cardiovasc Surg 2007;134:1055-1057
© 2007 The American Association for Thoracic Surgery

Brief Communication

Complicated acute type B aortic dissection with involvement of an aberrant right subclavian artery and rupture of a thoracoabdominal aortic aneurysm, Crawford type I: Successful emergency endovascular treatment

^a Department of Cardiothoracic Surgery, Juan Canalejo Hospital, A Coruña, Spain
^b Department of Interventional Radiology, Juan Canalejo Hospital, A Coruña, Spain.

Received for publication June 3, 2007; accepted for publication June 21, 2007.

^_* Address for reprints: Victor X. Mosquera, MD, Cardiac Surgery Department, Hospital Juan Canalejo, As Xubias n°84, CP 15006, A Coruña, Spain. (Email: vxmr@canalejo.org; vxmr@yahoo.es).

The first 20% of the full text of this article appears below.

Dr Mosquera

Although an aberrant right subclavian artery (ARSA) is the most common abnormality of aortic arch development, it is an unusual entity to encounter associated with thoracic aortic dissection. We report the successful endovascular treatment of this association in a critically ill patient.

Clinical Summary

An 80-year-old man was referred to our institution with the diagnosis of an acute aortic Stanford type B dissection (Figure 1, A). The computed tomographic scan images also showed a thoracoabdominal aortic aneurysm extending from an ARSA (Figure 1, B) to the esophageal hiatus (Crawford type I).

View larger version (77K):   Figure 1. Contrast-enhanced slides of computed tomographic image. Axial section of the thoracoabdominal aneurysm. A, Aortic type B dissection (white arrow) with the false lumen (posterior) compressing the true lumen (anterior). B, Origin of the ARSA (black arrow).

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