2.A Case of Partial Arch and Descending Aortic Replacement for a Ruptured Type B Acute Aortic Dissection
Ko Shibata ; Haruo Makuuchi ; Toshiya Kobayashi ; Masahide Chikada ; Hirosi Murakami ; Takamaro Suzuki ; Hirokuni Ono ; Kiyoshi Chiba ; Tokuichiro Nagata
Japanese Journal of Cardiovascular Surgery 2009;38(1):64-66
Ruptured type B acute aortic dissection (AAD) is a life-threatening condition, in which surgical treatment most often yields unsatisfactory results. We report a case of a ruptured type B AAD in a 67-year-old man detected on computed tomography that required a partial aortic arch replacement with reconstruction of the left subclavian artery with adjunct deep hypothermic circulatory arrest (DHCA). Although the patient had a postoperative stroke, he recovered markedly with rehabilitation. DHCA and open proximal anastomosis are useful for the surgical treatment of type B AAD, however, an elaborate strategy to prevent an intraoperative cerebral embolism is especially important.