Two Cases of Elective Surgery for Ruptured Thoracic Aortic Aneurysms in Patients on Antiplatelet Therapy

Abstract

Background: The operative risk for patients on antiplatelet therapy is greater for aortic operations. We present two patients on antiplatelet therapy who underwent elective surgery for impending ruptured thoracic aortic aneurysms after conservative treatment in the acute phase.
Case 1: A 75-year-old man with back pain was admitted to our hospital and a ruptured thoracic descending aortic aneurysm was diagnosed on computed tomography. As he was on antiplatelet therapy, we selected conservative treatment. He underwent a scheduled descending aortic aneurysm repair 24 days after admission.
Case 2: An 81-year-old woman was transported to our hospital with a ruptured distal aortic arch aneurysm. As she was on antiplatelet medications and her vital signs were stable, we treated her conservatively for 12 days before she underwent a total arch replacement. Both patients were discharged with no complications.
Conclusion: Although a ruptured thoracic aortic aneurysm is an indication for urgent surgery, patients on antiplatelet therapy can be treated conservatively with subsequent elective surgery if their vital signs and symptoms can be stabilized by anti-hypertensive therapy.