A Case of Acute Type B Aortic Dissection with Visceral Malperfusion and Impending Rupture of Abdominal Aortic Aneurysm

Abstract

A 52-year-old man was transported to our hospital with complaint of sudden onset of chest pain. Computed tomography showed type B aortic dissection which had a primary entry at the descending aorta near the branch of the left subclavian artery complicated by visceral malperfusion due to occlusion of the superior mesenteric artery (SMA) and impending rupture of abdominal aortic aneurysm (AAA). Thoracic endovascular aortic repair (TEVAR) was performed to seal the primary entry and expand the true lumen. Then, SMA stent was implanted, resulting in improved perfusion to the SMA. Y-graft replacement for AAA was also performed. After this operation, he suffered from prolonged diarrhea and needed to avoid oral intake for about three weeks. He was discharged on the 41st postoperative day without intestinal resection.