A Case of Successful Repair with Aortic Tailoring for Chronic Type B Aortic Dissection / 日本心臓血管外科学会雑誌

A 64-year-old woman with dyspnea on exertion was referred to our hospital. CT revealed type B aortic dissection with 7cm of aneurysm including a thrombus in the false lumen at the distal aortic arch. Four intimal tears at the distal aortic arch were closed directly during hypothermic circulatory arrest, and the descending thoracic aorta was tailored without a prosthetic graft after fixation of the dissecting adventitia to the intima at the distal portion of the false lumen. The postoperative course was uneventful and this patient was discharged on the 22nd postoperative day. Three years after surgery, the postoperative CT revealed no evidence of dilatation of the descending thoracic aorta as far as the abdominal aorta although the dissection of thoracoabdominal aorta remained. This technique is effective as an surgical option for chronic type B aortic dissection to minimize operative stress and complications.

Cerebral Embolism Following Attempted Balloon Occlusion of a Ruptured Abdominal Aortic Aneurysm / 日本心臓血管外科学会雑誌

The case presented is a 76-year-old woman with a ruptured abdominal aortic aneurysm. We tried to pass a Fogarty balloon catheter from the left subclavian artery for proximal occlusion of the ruptured aneurysm but failed to inset the balloon into the descending aorta. Although the aneurysm was safely replaced with a gelatine coated dacron graft, she developed cerebral embolism and never regained consciousness and died two months later. Balloon insertion through the subclavian artery may cause complication through dislodgement of atheromatous plaque and may induce cerebral embolism.

Aorto-Iliac Arteriovenous Fistula as a Complication of Abdominal Aortic Aneurysms: Report of Two Cases / 日本心臓血管外科学会雑誌

Two patients with an aorto-iliac arteriovenous fistula as a complication of abdominal aortic aneurysms were presented. Both patients showed pulsating abdominal mass, and swelling of unilateral leg. The fistula was preoperatively diagnosed in one and in another it was suspected intraoperatively by careful palpation of continuous thrill on the aneurysm. Successful surgical management was accomplished in both patients. Awareness of this clinical entities is necessary to manage this rare complication in abdominal aortic aneurysm surgery.