A Surgical Case of Acute Aortic Dissection with Antiphospholipid Syndrome.
10.4326/jjcvs.30.311
- VernacularTitle:抗リン脂質抗体症候群に合併した急性大動脈解離の1手術例
- Author:
Tsuneo Nakajima
;
Hiroto Kitahara
;
Tetsuya Kono
;
Keizo Ohta
;
Tamaki Takano
;
Ryo Hasegasa
;
Hirohisa Goto
;
Hirofumi Nakano
;
Hideo Kuroda
;
Jun Amano
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2001;30(6):311-313
- CountryJapan
- Language:Japanese
-
Abstract:
The patient was a 52-year-old man with a history of antiphospholipid syndrome (APS), renal dysfunction and myasthenia gravis (MG). On May 2, 1998, he had sudden chest pain while sleeping. Enhanced computed tomography revealed acute aortic dissection (DeBakey type I). We performed emergency graft replacement of the ascending aorta and the aortic arch under extracorporeal circulation. Because of perioperative anuria, we used peritoneal dialysis (PD) just after the operation. Two days after the operation, we performed re-intubation nine hours after the extubation of the tracheal tube, and performed re-extubation three days later. For a while, his postoperative course was uneventful, but because of gradual worsening of APS, we administered more prednisolone, but 74 days after the operation, he died of multiple organ failure caused by an opportunistic infection, sepsis, and disseminated intravascular coagulation. This was very rare case of acute aortic dissection with MG and APS. After administration of more glucocorticoids, it is important to be wary of opportunistic infections.