Abstract
A rare case of chronic traumatic dissecting aneurysm of DeBakey type IIIb was managed radically under temporary axillofemoral bypass.
A 47-year-old male had been suffering from hypertension for five years. He was treated two and half years ago for a blow to the chest wall caused by a traffic accident. Six months ago he was admitted to a neighboring hospital with transient lack of consciousness. Chest roentogenogram demonstrated evidence of widening of the mediastinum, prominence of the aortic knob and tracheal shift to the right. Digital subtraction angiogram (DSA) showed type IIIb dissection oridinating distal to the left subclavian artery and re-entering in the region of the celiac artery. Under temporary bypass between the right axillary and right femoral arteries, a 26 mm woven Dacron graft was inserted at the aneurysmal lesion of thoracic aorta, and the re-entry lesion was reconstructed with a Dacron patch. Postoperatively, he has been well without complications, and examinations including DSA have demonstrated favorable results.
