RESUMO
A 60-year-old man underwent open surgery for chronic dissecting abdominal aorta accompanied with a horseshoe kidney. Through open laparotomy, the abdominal aortic aneurysm was exposed without revision of the horseshoe kidney. Cold ringer solution was infused to accessory renal arteries for renal protection. After supra-renal clamping, proximal anastomosis was then performed at the level just below the renal arteries. Abdominal cross clamp time at the level of the supra-renal arteries was 23 min. Median and right accessory arteries were reattached with an ischemic time of 73 and 103 min, respectively. Although serum creatine was elevated a preoperative level of 1.17 mg/dl to 3.63 mg/dl at postoperative day 2, that was gradually decreased to nearly preoperative level of 1.25 mg/dl at discharge. Postoperative enhanced CT demonstrated patency of the reattached accessory arteries. The patient was discharged without major complication on postoperative day 21. One year postoperatively, his follow-up course was uneventful without deterioration of renal function.
RESUMO
A 79-year-old woman with left hemiplegia and loss of consciousness was transferred to a previous hospital. She underwent a CT-scan of the aorta and CT-perfusion of the brain and was diagnosed with Stanford type A acute aortic dissection complicated with cerebral malperfusion with narrowing of the right carotid artery region. She was transferred to our hospital and underwent emergency ascending aorta replacement. Preoperative CT perfusion findings predicted improvement of neurological symptoms after aortic repair, and she had no neurological complications postoperatively.
