AI Article Synopsis
- Endovascular and open surgical repair methods are debated for treating descending thoracic aortic dissection, as illustrated in a case involving a 60-year-old woman with serious complications.
- The patient initially underwent emergency endovascular stent-grafting but faced ongoing symptoms due to a contained rupture, leading to a second surgery for stent removal and aorta reconstruction.
- The surgery was successful, and she was discharged after 13 days; genetic testing later confirmed Marfan syndrome, suggesting that endovascular repair may be a suitable first step before more definitive procedures.
Article Abstract
Endovascular and open surgical repair have been used in patients with descending thoracic aortic dissection; however, the appropriate treatment is debated. We describe the case of a 60-year-old woman who had a symptomatic, chronic, residual, descending thoracic aortic dissection that was complicated by an aortobronchial fistula. She underwent emergent thoracic endovascular stent-grafting but remained symptomatic. Computed tomographic angiograms showed a contained rupture into the lower lobe of the left lung. The patient underwent definitive surgery to remove the stents, reconstruct the aorta, and resect the nonviable lung tissue. The remainder of her postoperative course was uneventful, and she was discharged from the hospital 13 days after the 2nd operation. Results of genetic testing confirmed an earlier presumptive diagnosis of Marfan syndrome. In an emergency, the best initial option for patients with a complicated descending thoracic aortic dissection might be thoracic endovascular aortic repair, which could serve as a bridge to definitive open repair.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004497 | PMC |
| http://dx.doi.org/10.14503/THIJ-12-2901 | DOI Listing |
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