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Acute type A aortic dissection with intestinal ischemia predicted by serum lactate elevation
Satoshi Muraki1, Johji Fukada, Kiyofumi Morishita
1Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Summary
Acute aortic dissection can lead to mesenteric ischemia. Early diagnosis and treatment of this complication are crucial, and serial serum lactate monitoring aids in timely intervention.
Area of Science:
- Cardiovascular Surgery
- Gastroenterology
- Critical Care Medicine
Background:
- Acute aortic dissection, particularly type A, poses significant risks for visceral organ complications.
- Mesenteric ischemia is a known but challenging complication of acute aortic dissection, often presenting with vague symptoms.
Observation:
- A case of acute type A aortic dissection developed perioperative intestinal ischemia.
- Clinical manifestations of intestinal ischemia appeared on the second postoperative day.
Findings:
- Serial monitoring of serum lactate levels using a conventional blood gas analyzer facilitated early diagnosis.
- Prompt lactate monitoring enabled timely treatment of the intestinal ischemia.
Implications:
- Serum lactate level monitoring is a valuable tool for the early detection of mesenteric ischemia in patients with acute aortic dissection.
- This approach can guide timely therapeutic interventions, potentially improving patient outcomes in complex aortic surgeries.