Abstract
A 60-year-old man developed right leg pain and chest discomfort.
CT showed an acute Stanford Type B aortic dissection;the dissection extended from the descending aorta to both common iliac arteries.
Although the true lumen of the celiac artery, as well as the superior mesenteric arter, was narrow, echography did not show that blood flow was poor in these vessels.
The right common iliac artery was completely occluded.
A femorofemoral bypass was performed, and then the blood flow of the right leg was reperfused.
After the operation, abdominal angina was noted, and the dissecting aortic aneurysm of the descending aorta was found to have expanded.
The next operation for the dissecting aortic aneurysm of the descending aorta required a superior mesenteric artery bypass, a right gastroepiploic artery bypass, and a right axillofemoral artery bypass to have been done.
Since the patient's abdominal angina had improved, he was discharged.
About one month after discharge, the replacement of the dissecting aortic aneurysm with a syntheticgraft was performed.
A femorofemoral bypass graft was used as the aortic inflow given the perfusion requirements of the head, abdomen, and leg.
The postoperative course was uneventful, and the patient was discharged on postoperative day 20.
