Salvage of an acutely ruptured thoracic aortic aneurysm during CPR.
J Endovasc Ther
; 9 Suppl 2: II67-71, 2002 Jun.
Article
em En
| MEDLINE
| ID: mdl-12166844
ABSTRACT
PURPOSE:
To report the successful endovascular treatment of a ruptured thoracic aortic aneurysm during cardiopulmonary resuscitation. CASE REPORT A 72-year-old woman with a type B aortic dissection treated conservatively for 8 years was referred for rupture of a 16-cm aneurysm of the descending thoracic aorta. During transfer to the operating room, the patient suffered cardiac arrest; cardiopulmonary resuscitation (CPR) was initiated. A few minutes later during CPR, the surgical procedure began with a cutdown of the right femoral artery and insertion of a guidewire and an aortic occlusion balloon, which was inflated at the origin of the left subclavian artery (LSA). Blood pressure was immediately measurable. By only partially deflating the occluding balloon, a thoracic stent-graft was advanced above it and deployed at the origin of the LSA while rapidly deflating and retracting the occluding balloon. Three stent-grafts were required to cover 27 cm of the descending aorta. The patient was partly ventilator dependent for 3 months due to a massive pleural hematoma that was not evacuated. At the 10-month follow-up, the patient is fully recovered without any sign of respiratory dysfunction or any other sequela. CT scans reveal that the massive hematoma is almost completely resolved.CONCLUSIONS:
This case illustrates that optimal collaboration between anesthesiologists, interventional radiologists, and vascular surgeons with appropriate resources can significantly expand the possibilities of emergent treatment in the face of aortic rupture.
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Base de dados:
MEDLINE
Assunto principal:
Ruptura Aórtica
/
Stents
/
Reanimação Cardiopulmonar
/
Aneurisma da Aorta Torácica
/
Implante de Prótese Vascular
Limite:
Aged
/
Female
/
Humans
Idioma:
En
Ano de publicação:
2002
Tipo de documento:
Article