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J Thorac Cardiovasc Surg 2008;135:1380-1382
© 2008 The American Association for Thoracic Surgery

Brief Communication

Complicated acute type B aortic dissection involving the arch: Treatment by simultaneous hybrid approach under local anesthesia

^a Department of Cardiac Surgery, University "Federico II," Naples, Italy
^b Department of Cardiology, University "Federico II," Naples, Italy

Received for publication March 20, 2007; accepted for publication April 19, 2007.

^_* Address for reprints: Gabriele Iannelli, MD, Via Santo Strato, 8, 80123 Naples, Italy. (Email: gabrieleiannelli@libero.it).

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

See related editorial on page 1201

 

We herein report the case of a high-risk patient with complicated acute type B aortic dissection (B-AD) involving the arch up to both common iliac arteries. The patient was treated by a simultaneous hybrid approach accomplished with local anesthesia.

Clinical Summary

A 56-year-old man was admitted to the emergency care unit for chest pain and hypertension because of an acute B-AD involving the distal arch, left subclavian artery (LSA), visceral vessels, and the abdominal aorta up to both common iliac arteries ( Figure 1). An ascending aortic aneurysm, with a maximum diameter of 42 mm, was also found. An emergency surgical option was considered because of the substantial risk of impending rupture of the false lumen, highlighted by the persistence of chest pain and unresponsive hypertension. Our strategy consisted of a simultaneous hybrid treatment.

View larger version (42K):   Figure 1. Multislice spiral computed tomographic angiogram shows the dissection involving the distal arch, left subclavian artery, visceral vessels, and the abdominal aorta up to both . . . [Full Text of this Article]

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