Hybrid Strategy for Residual Arch and Thoracic Aortic Dissection following Acute Type A Aortic Dissection Repair.

Progressive dilatation of the false lumen in the arch and descending aorta has been encountered in one-third of survivors as a late sequelae following repair of ascending aortic dissection. Conventional treatment for the same requiring cardiopulmonary bypass and deep hypothermic circulatory arrest is associated with high morbidity and mortality especially in the elderly cohort of patients. Herein we report a case of symptomatic progressive aneurysmal dilatation of residual arch and descending thoracic aortic dissection following repair of type A aortic dissection, successfully treated by total arch debranching and ascending aortic prosthesis to bicarotid and left subclavian bypass followed by staged retrograde aortic stent-graft deployment.

Chronic mesenteric ischemia and therapeutic paradigm of mesenteric revascularization.

Chronic mesenteric ischemia is a life-threatening clinical problem resulting in death from inanition and/or bowel infarction, if left untreated, albeit low disease prevalence. Typical presentation is postprandial abdominal pain, severe weight loss, and altered bowel habit. Surgical revascularization of the superior mesenteric artery provides effective long-term treatment for chronic intestinal ischemia.

Intact giant abdominal aortic aneurysm due to Takayasu arteritis.

A 35-year-old male fisherman was admitted with complaints of increasing back pain and abdominal discomfort of 1-year duration. Physical examination revealed a prominently visible, expansile, pulsatile, well-defined, nontender abdominal mass in the epigastric, umbilical and both lumbar areas. Computed tomographic (CT) angiography revealed a large juxtarenal aortic aneurysm with a maximum transverse diameter of 14.