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THE JOURNAL OF CARDIOVASCULAR SURGERY

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

Copyright © 2000 EDIZIONI MINERVA MEDICA

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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