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[A successful surgical case of chronic DeBakey IIIb dissecting aortic aneurysm associated with right-sided aortic

K Tsunemi1, S Hasegawa, H Horimoto

  • 1Department of Thoracic Surgery, Osaka Medical College, Takatsuki, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|November 20, 2001
PubMed

Insights

This case report details a rare chronic DeBakey IIIb dissecting aneurysm combined with a right-sided aortic arch. Surgical repair successfully closed the false lumen, offering a positive outcome for this complex aortic dissection.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Dissecting aortic aneurysms are life-threatening conditions requiring prompt diagnosis and treatment.
  • Complex aortic arch anomalies, such as right-sided aortic arch, can complicate surgical approaches.
  • Chronic aortic dissections present unique challenges due to potential tissue friability and extensive false lumen formation.

Observation:

  • A 51-year-old male presented with a 3-year history of chronic DeBakey IIIb dissecting aortic aneurysm.
  • The patient had a rare anatomical variation: a right-sided aortic arch and aberrant left subclavian artery.
  • Surgical intervention involved a right posterolateral thoracotomy with entry tear closure under hypothermic circulatory arrest, followed by false lumen plication.

Findings:

  • The surgical procedure successfully achieved complete closure of the thoracic false lumen.
  • Post-operative recovery was uneventful, with the patient discharged on the 21st post-operative day.
  • Intra-venous digital subtraction angiography confirmed the successful obliteration of the false lumen.

Implications:

  • This case highlights the successful surgical management of a rare combination of chronic aortic dissection and right-sided aortic arch.
  • It underscores the importance of meticulous pre-operative assessment and tailored surgical techniques for complex aortic pathologies.
  • Effective management strategies for dissecting aneurysms with associated aortic arch anomalies can lead to favorable patient outcomes.

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