[Emergent Thoracic Endovascular Aortic Repair and Subxiphoid Pericardiotomy for Retrograde Type A Acute Aortic Dissection with Cardiac Tamponade;Report of a Case]. 2017

Masatoshi Sunada, and Yusuke Suzuki, and Takashi Takano, and Hirofumi Midorikawa, and Megumu Kanno
Department of Cardiovascular Surgery, Southern Tohoku General Hospital, Koriyama, Japan.

Type A acute aortic dissection has a high rate of mortality. Emergent surgical repair is the gold standard treatment, but some patients cannot tolerate the open surgery. Here, we report an 82-year-old patient with a history of cerebral infarction and cerebral bleeding who presented with a depressed level of consciousness and who was in a state of shock. A computed tomography (CT) scan showed cardiac tamponade associated with retrograde type A aortic dissection(RAAD), with a primary entry tear at a distal site of the left subclavian artery. We therefore performed emergent primary entry closure with stent grafting using the Conformable Gore Tag device and emergent drainage of the cardiac tamponade with subxiphoid pericardiotomy. Postoperative CT scan showed complete closure of the primary entry tear and a completely thrombosed false lumen. Primary entry closure with stent grafting could be an effective option for RAAD that meets anatomical criteria.

UI MeSH Term Description Entries
D002305 Cardiac Tamponade Compression of the heart by accumulated fluid (PERICARDIAL EFFUSION) or blood (HEMOPERICARDIUM) in the PERICARDIUM surrounding the heart. The affected cardiac functions and CARDIAC OUTPUT can range from minimal to total hemodynamic collapse. Pericardial Tamponade,Cardiac Tamponades,Pericardial Tamponades,Tamponade, Cardiac,Tamponade, Pericardial,Tamponades, Cardiac,Tamponades, Pericardial
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D000784 Aortic Dissection A tear in the inner layer of the AORTA leading to interstitial HEMORRHAGE, and splitting (dissecting) of the aortic TUNICA MEDIA layer. It typically begins with a tear in the TUNICA INTIMA layer. Aneurysm, Dissecting,Aortic Dissecting Aneurysm,Dissecting Aneurysm,Dissecting Aneurysm Aorta,Aneurysm Aorta, Dissecting,Aneurysm, Aortic Dissecting,Aorta, Dissecting Aneurysm,Aortic Dissecting Aneurysms,Aortic Dissections,Dissecting Aneurysm Aortas,Dissecting Aneurysm, Aortic,Dissecting Aneurysms,Dissection, Aortic
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017545 Aortic Aneurysm, Thoracic An abnormal balloon- or sac-like dilatation in the wall of the THORACIC AORTA. This proximal descending portion of aorta gives rise to the visceral and the parietal branches above the aortic hiatus at the diaphragm. Aneurysm, Thoracic Aorta,Thoracic Aorta Aneurysm,Thoracic Aortic Aneurysm,Aneurysm, Thoracic Aortic,Aorta Aneurysm, Thoracic,Thoracic Aorta Aneurysms,Thoracic Aortic Aneurysms
D057510 Endovascular Procedures Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY. Endovascular Techniques,Intravascular Procedures,Intravascular Techniques,Endovascular Procedure,Endovascular Technique,Intravascular Procedure,Intravascular Technique,Procedure, Endovascular,Procedure, Intravascular,Procedures, Endovascular,Procedures, Intravascular,Technique, Endovascular,Technique, Intravascular,Techniques, Endovascular,Techniques, Intravascular
D019917 Blood Vessel Prosthesis Implantation Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels. Implantation, Blood Vessel Prosthesis,Vascular Prosthesis Implantation,Implantation, Vascular Prosthesis,Prosthesis Implantation, Vascular

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