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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 1998 February;39(1):25-30

language: English

Spontaneous ret­ro­grade dis­sec­tion of ­the ­entire tho­rac­ic aor­ta orig­i­nat­ing in ­the abdom­i­nal aor­ta. Case ­report ­and ­review of ­the lit­er­a­ture

Sasai T., Miki Sh., Ueda Y., Tahata T., Ogino H., Morioka K., Matsubayashi K., Nomoto T.

From ­the Department of Cardiovascular Surgery, Tenri Hospital, Tenri, Nara, Japan


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Spontaneous ret­ro­grade tho­rac­ic exten­sion of ­the abdom­i­nal aor­tic dis­sec­tion is extreme­ly ­rare ­and dif­fi­cult to man­age. Only ­five cas­es ­have ­been pre­vi­ous­ly report­ed in ­the English lit­er­a­ture (dis­sec­tion reach­ing ­the ascend­ing aor­ta in ­four, dis­sec­tion lim­it­ed in ­the descend­ing tho­rac­ic aor­ta in ­one), ­and ­all ­the cas­es of dis­sec­tion ­which ­reached ­the ascend­ing aor­ta ­were ­lethal. We here­in ­report ­one ­case of a 37-­year-­old ­man ­who ­was oper­at­ed on ­for spon­ta­ne­ous ret­ro­grade dis­sec­tion of ­the ­entire tho­rac­ic aor­ta orig­i­nat­ing in ­the suprar­en­al abdom­i­nal aor­ta. Preoperative aor­to­gram ­revealed ­the ­site of ­the inti­mal ­tear ­just ­above ­the ­celiac ­artery. He urgent­ly under­went ­graft replace­ment of ­the descend­ing tho­rac­ic aor­ta ­and ­the abdom­i­nal aor­ta ­with reim­plan­ta­tion of ­the thor­a­coab­dom­i­nal vis­cer­al arter­ies. Although ­the ­patient ­had to under­go ­the sec­ond oper­a­tion ­for ­the dis­sec­tion of ­the remain­ing tho­rac­ic aor­ta ­four ­months post­op­er­a­tive­ly, he ­has ­been ­doing ­well 18 ­months ­after ­the sec­ond oper­a­tion.

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