Clinical Experiences of Dissecting Aortic Aneurysm with Organ Ischemia / 日本心臓血管外科学会雑誌

ABSTRACT

We studied 6 surgical cases of dissecting aortic aneurysm with organ ischemia, consisting of 4 cases of DeBakey type I dissection and 2 cases of DeBakey type III b dissection and the average age was 62 years old. The ischemic organs were, the brain and upper extremities, intestine and kidney, kidney, kidney and lower extremity, and bilateral lower extremities, respectively. We performed the graft replacements of the ascending aorta or ascending aorta and arch for DeBakey type I dissection, and bypass or Y-graft replacement for DeBakey type III b dissection. In one case of DeBakey type I dissection we performed a second Y-graft replacement two days after the first operation. MNMS (myonephropathic metabolic syndrome) developed in two cases of 3 lower extremity ischemia. The results were unsatisfactory because 3 patients died. To improve of the outcome of surgical treatment in case of dissecting aortic aneurysm with organ ischemia, preoperative appropriate diagnosis and appropriate surgical planning are necessary.