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Successful Open Graft Replacement for Acute Stanford Type B Aortic Dissection with Bilateral Lower Limb Ischemia and Postoperative Myonephropathic Metabolic Syndrome / 日本心臓血管外科学会雑誌
Japanese Journal of Cardiovascular Surgery ; : 50-53, 2013.
Article in Japanese | WPRIM | ID: wpr-362985
ABSTRACT
A 52-year-old man suddenly felt severe back pain and numbness in the lower extremities. Enhanced CT revealed an acute Stanford type B dissection. The true lumen of the left common iliac artery was severely compressed by the thrombosed false lumen. We performed a femoro-femoral bypass and symptoms in the lower limbs disappeared. On day 4 of hospitalization, the patient suddenly presented with pain at rest and cyanosis in both lower extremities. CT revealed nearly total occlusion of the abdominal aorta due to severe compression of the false lumen. We performed emergency open graft replacement in the infrarenal aorta. Although ischemia in the lower extremities improved, the patient developed myonephropathic metabolic syndrome (MNMS) and received continuous hemodiafiltration to treat acute renal insufficiency. The patient's ankle-branchial pressure index improved and he was weaned from continuous hemodiafiltration. The patient had no paralysis and was able to walk unassisted, so he was discharged on day 34 of hospitalization. In the event of acute aortic dissection and organ ischemia, emergency open graft replacement may be required and must be performed promptly as a lifesaving measure.

Full text: Available Index: WPRIM (Western Pacific) Language: Japanese Journal: Japanese Journal of Cardiovascular Surgery Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Japanese Journal: Japanese Journal of Cardiovascular Surgery Year: 2013 Type: Article