Emergent Thoracic Endovascular Aortic Repair and Subxiphoid Pericardiotomy for Retrograde Type A Acute Aortic Dissection with Cardiac Tamponade;Report of a Case

Masatoshi Sunada, Yusuke Suzuki, Takashi Takano, Hirofumi Midorikawa, Megumu Kanno

Research output: Contribution to journalArticlepeer-review

Abstract

Type A acute aortic dissection has a high rate of mortality. Emergent surgical repair is the gold standard treatment, but some patients cannot tolerate the open surgery. Here, we report an 82-year-old patient with a history of cerebral infarction and cerebral bleeding who presented with a depressed level of consciousness and who was in a state of shock. A computed tomography (CT) scan showed cardiac tamponade associated with retrograde type A aortic dissection(RAAD), with a primary entry tear at a distal site of the left subclavian artery. We therefore performed emergent primary entry closure with stent grafting using the Conformable Gore Tag device and emergent drainage of the cardiac tamponade with subxiphoid pericardiotomy. Postoperative CT scan showed complete closure of the primary entry tear and a completely thrombosed false lumen. Primary entry closure with stent grafting could be an effective option for RAAD that meets anatomical criteria.

Original languageEnglish
Pages (from-to)960-964
Number of pages5
JournalKyobu geka. The Japanese journal of thoracic surgery
Volume70
Issue number11
Publication statusPublished - 2017 Oct 1
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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