General Thoracic and Cardiovascular Surgery

, Volume 59, Issue 1, pp 34–37 | Cite as

Ruptured thoracic descending aortic aneurysm coexisting with DeBakey type IIIb aortic dissection

  • Shinichiro Taniguchi
  • Ryuichiro Shibata
  • Daisuke Onohara
Case Report
  • 62 Downloads

Abstract

We have encountered a rare case of ruptured true thoracic aortic aneurysm coexisting with DeBakey type IIIb aortic dissection. The patient was a 67-year-old woman who had a past history of hypertension and cerebral infarction. She experienced DeBakey type IIIb acute aortic dissection, and initially conservative medical treatment was carried out. However, the patient suddenly went into shock, and emergency contrast-enhanced computed tomography revealed the presence of a ruptured true thoracic aortic aneurysm coexisting with the type IIIb dissection. Replacement of the descending aorta was performed through a left thoracotomy using circulatory arrest and deep hypothermia. The rupture site and intimal tear were located in the middle of the aneurysm. Open proximal and distal anastomoses were carried out using a 22 × 10 mm gelatin-covered Dacron graft. The patient was discharged from our hospital uneventfully on the 33rd postoperative day.

Key words

Ruptured true thoracic aortic aneurysm DeBakey type IIIb aortic dissection Graft replacement Circulatory arrest Deep hypothermia cardiopulmonary bypass 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Cambria RP, Brewster DC, Moncure AC, Steinberg FL, Abbot WM. Spontaneous aortic dissection in the presence of coexistent or previously repaired atherosclerotic aortic aneurysm. Ann Surg 1988;208:619–624.CrossRefPubMedGoogle Scholar
  2. 2.
    Roberts CS, Roberts WC. Combined thoracic aortic dissection and abdominal aortic fusiform aneurysm. Ann Thorac Surg 1991;52:537–540.CrossRefPubMedGoogle Scholar
  3. 3.
    Slater EE, DeSanctis RW. The clinical recognition of dissecting aortic aneurysm. Am J Med 1976;60:625.CrossRefPubMedGoogle Scholar
  4. 4.
    Stanson AW, Kazmier FJ, Hollier LH, Edwards WD, Pairolero PC, Sheedy PF, et al. Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations. Ann Vasc Surg 1986;1:15–23.PubMedGoogle Scholar
  5. 5.
    Harris JA, Bis KG, Glover JL, Bendick PJ, Shetty A, Brown OW. Penetrating atherosclerotic ulcers of the aorta. J Vasc Surg 1994;19:90–98.PubMedGoogle Scholar
  6. 6.
    Kouchoukos NT, Masetti P, Rokkas CK, Murphy SF, Blackstone EH. Safety and effi cacy of hypothermic cardiopulmonary bypass and circulatory arrest for operations on the descending thoracic and thoracoabdominal aorta. Ann Thorac Surg 2001;72:699–707.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2011

Authors and Affiliations

  • Shinichiro Taniguchi
    • 1
    • 2
  • Ryuichiro Shibata
    • 1
    • 2
  • Daisuke Onohara
    • 1
    • 2
  1. 1.Department of Cardiovascular Surgery, Graduate School of MedicineNagasaki UniversityNagasakiJapan
  2. 2.Department of Cardiovascular SurgerySasebo Chuo HospitalNagasakiJapan

Personalised recommendations