Aortic dissection is an uncommon yet frequently fatal illness. Patients generally present with tearing chest pain with possible acute hemodynamic instability. Hence, early diagnosis and intervention is critical for survival. This is a case of a 62-year-old male who was transferred to our emergency department for severe chest pain, left side hemiplegia, left hemianopsia, left facial weakness, suggesting a right-sided stroke. A chest computed tomography angiogram showed an extensive circumferential aortic dissection of the intimal layer involving the great vessels. Antiplatelet medications were withheld, nicardipine was started, and the cardiothoracic surgeon was consulted. There was no indication for surgery, and patient was admitted to the intensive care unit. We highlight here the importance of considering an aortic dissection in patients who present with neurological symptoms and an acute history of tearing chest pain.
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http://dx.doi.org/10.11604/pamj.2023.44.91.38533 | DOI Listing |
Cureus
December 2024
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga University, Saga, JPN.
Background The effect of surgeons' years of experience on the outcomes of acute type A aortic dissection (ATAAD) repair has not yet been studied. This study aimed to evaluate the association between the surgeon's years in practice and the outcomes of ATAAD repair. Methods Surgical records of ATAAD repairs performed at Saga University Hospital between 2004 and 2020 were reviewed.
View Article and Find Full Text PDFAm J Case Rep
January 2025
Department of Cardiovascular Surgery, Fujian Heart Medical Center, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China.
BACKGROUND Acute intramural hematoma (IMH) of the ascending thoracic aorta and aortic arch is a life-threatening condition, particularly in elderly patients with comorbidities, due to its risk of progression and rupture. Unlike aortic dissection, IMH lacks an intimal tear, influencing both clinical presentation and treatment strategy. This report describes a 74-year-old hypertensive woman with type A IMH and a penetrating atherosclerotic ulcer (PAU), managed with a hybrid surgical approach that combines external Dacron wrapping of the ascending aorta and endovascular stenting of the aortic arch with in-situ fenestration of the supra-aortic arteries.
View Article and Find Full Text PDFJ Vasc Surg
January 2025
Vascular Surgery, University of Bologna, DIMEC, Bologna, Italy; Vascular Surgery Unit, IRCCS Sant'Orsola, Bologna, Italy.
Introduction/aim: The partial deployment technique (PDT) is an unconventional option of T-branch deployment to allow target arteries (TAs) cannulation/stenting from the upper arm access, in case of narrow (NPA: <25mm) or severely angulated (APA: >60°) aorta. Aim of this study was to report outcomes of the endovascular repair of complex aortic (c-AAAs) and thoracoabdominal (TAAAs) aneurysms by T-branch and PDT.
Methods: All consecutive patients underwent urgent endovascular repair of c-AAAs and TAAAs by T-branch (Cook-Medical, Bloomington, IN, US) and PDT from 2021 to 2023 were analyzed.
Interdiscip Cardiovasc Thorac Surg
January 2025
Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan.
Cervical aortic arch (CAA) is a rare malformation. Herein, we report a 58-year-old female patient diagnosed with left CAA with descending aortic aneurysm. Initially, the descending aorta replacement was planned via left rib-cross thoracotomy.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Vascular Surgery, Zhangzhou Affiliated Hospital of FuJian Medical University, Zhangzhou, Fujian Province, 363000, China.
Background: Thoracic aortic endovascular repair (TEVAR) is the most commonly employed method for treating type B aortic dissection (TBAD). One of the primary challenges in TEVAR is the reconstruction of the left subclavian artery (LSA). Various revascularization strategies have been utilized, including branch stent techniques, fenestration techniques, chimney techniques, and hybrid techniques.
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