Abstract
Patients with Stanford type B acute aortic dissections complicated with malperfusion are at a high risk for open surgical repair. Thoracic endovascular aortic repair (TEVAR) has been used for patients with complications such as malperfusion. Patients who have undergone TEVAR show lower mortality and morbidity rates than those who have undergone open surgical repair. We experienced the case of a 79-years-old woman who had a Stanford type B acute aortic dissection complicated with acute kidney injury caused by renal malperfusion. We performed hemodialysis for acute kidney injury. The expansion of the false lumen caused narrowing of the true lumen and renal malperfusion. An emergent TEVAR was done under general anesthesia. We used intraoperative transesophageal echocardiography (TEE) to assist stent graft positioning and to evaluate blood flow of both true and false lumens. The patient's renal function was recovered, and she did not require postoperative hemodialysis. We conclude that TEVAR is useful for critical ill patients with Stanford type B acute aortic dissections complicated with renal malperfusion, and early diagnosis of renal malperfusion is important for preventing irreversible kidney injury.
