A Case of Four-channel Aortic Dissection

Abstract

Four-channel aortic dissection is rare. We reported our experience that we had performed an operation for four-channel aortic dissection because the aortic dissection had gotten worse from a three-channel aortic dissection and its diameter had extended. Our case was a 44-year-old woman with Marfan syndrome. She undewent a Bentall procedure and total arch replacement for Stanford A aortic dissection in 2008. Her postoperative course was uneventful. So, we requested observation of her condition to a local doctor. She underwent a CT in 2014. We found her descending aortic dissection changed to a three-channel aortic dissection. Next year, she was taken to another hospital via ambulance for sudden back pain. Then, her descending aorta’s diameter extended and her three-channel aortic dissection changed four-channel aortic dissection. A week later, her descending aortic diameter extended further. So she was transferred to our hospital. We performed a thoracoabdominal aortic replacement. Her postoperative course was uneventful, and she was discharged without incident. Four-aortic dissection is high risk of rupture, so we think such cases need surgical treatment as soon as possible.