ABSTRACT
Clinical condition, hostile anatomy, and previous heart/aortic surgery may preclude standard open surgery and standard endovascular interventions in patients with complex aortic pathologies. We report our initial experience using the transapical endovascular approach to treat a type IA endoleak after transfemoral endovascular graft repair for a contained rupture of a penetrating descending aortic ulcer; an ascending aortic anastomotic pseudoaneurysm after open surgical repair of an ascending aortic dissection; and a type A aortic dissection after minimally invasive mitral valve repair. There were no neurologic or cardiovascular complications, and the 30-day mortality was 0%.
Subject(s)
Aneurysm, False/surgery , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Endoleak/surgery , Endovascular Procedures/methods , Aortic Dissection/complications , Aortic Dissection/diagnostic imaging , Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/diagnostic imaging , Echocardiography, Transesophageal/methods , Endoleak/diagnostic imaging , Endoleak/etiology , Female , Follow-Up Studies , Heart Ventricles/diagnostic imaging , Heart Ventricles/surgery , Humans , Male , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Prosthesis Failure , Punctures/methods , Radiography , Reoperation/methods , Risk Assessment , Sampling Studies , Thoracotomy/methods , Treatment Outcome , Vascular Surgical Procedures/methodsABSTRACT
Spontaneous coronary artery dissection (SCAD) is a rare and potentially deadly disease without a clear and universal treatment. Medical as well as mechanical interventions, including percutaneous and coronary bypass surgery, have been used. We present two dissimilar cases of SCAD that required markedly different treatments reflecting the variety in clinical presentation and outcome. A brief review of the literature is included.
