A man in his early 60 s who worked at a waste disposal plant had fallen into the refuse pit and was immediately taken to the emergency department for treatment. After 8 days without recovering consciousness, the man died. Antemortem contrast-enhanced computed tomography at the emergency department indicated Stanford type B/DeBakey type IIIb aortic dissection. The autopsy showed a sharp and transverse intimal tear 0.6 cm in length in the aortic isthmus and fractures in the 5th-6th thoracic vertebrae. No structural abnormalities in arterial walls were noted on histopathological examination. The traumatic aortic dissection induced by falling is rare, compared with vehicle crash. Although the verification process was challenging, the cause of death was ultimately concluded as traumatic aortic dissection due to falling into the refuse pit. The following observations were cited as evidence: (1) the location and feature of the intimal tear, (2) the positional relationship between the impact site and the entry tear, and (3) the circumstance of clash impact onto the "cushion" of accumulated waste in the refuse pit. Inquiries into the cause of death, such as those made in this report, are required to provide detailed information on the circumstances of the accident, postmortem examinations, and careful consideration.
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http://dx.doi.org/10.1007/s12024-022-00527-9 | DOI Listing |
We present the case of a 74-year-old female patient with a 50 mm ascending aortic aneurysm who underwent ascending aorta replacement. During routine open heart surgery, suboptimal flow in the cardiopulmonary bypass circuit, led to the discovery of a type B aortic dissection with substantial flow in the false lumen. Conservative management was chosen, focusing on blood pressure control in the ICU.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
January 2025
Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
Objective: We present our experience with endovascular Bentall procedure (Endo-Bentall) using a modular valve conduit (Endo-Bentall) in high-risk patients with aortic root pathologies.
Methods: The physician constructed Endo-Bentall device is composed of a self-expanding transcatheter aortic valve (TAVR), aortic endovascular stent graft (TEVAR), and two wire-reinforced fenestrations for coronary artery stenting. The TAVR valve is sutured into an appropriately sized TEVAR graft.
J Thorac Cardiovasc Surg
January 2025
University of Maryland School of Medicine, Division of Cardiothoracic Surgery. Electronic address:
Objective: Over 30% of patients presenting with acute type A aortic dissection (ATAAD) are considered high - risk or inoperable. This study aims to investigate the early and mid-term outcomes of complex endovascular aortic repair of aortic root, ascending aorta, and aortic arch among patients with ATAAD.
Methods: From January 2018 to January 2023, 29 patients who were considered high risk for open operation underwent endovascular aortic repair.
Indian J Thorac Cardiovasc Surg
February 2025
Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China.
Purpose: Acute aortic dissection is a serious cardiovascular emergency with a high mortality rate. Its pathogenesis is complex and remains unclear. This study aimed to assess the connection between the levels of genetically predicted circulating metabolites and the risk of aortic dissection.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Chinese Institutes for Medical Research and Anzhen Hospital, Capital Medical University, Beijing, China.
Although open repair remains the mainstream treatment for aortic arch dissection, its surgical complexity and perioperative complications are significant. We developed a novel stentgraft system for less-invasive endovascular aortic arch repair. We successfully performed a total percutaneous transfemoral endovascular repair of aortic arch dissection using a novel off-the-shelf endograft system.
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