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Type B dissection complicated with subacute visceral ischemia
Satoshi Yamashiro1, Yukio Kuniyoshi, Kazufumi Miyagi
1Second Department of Surgery, School of Medicine, Faculty of Medicine, University of Ryukyus, Nishihara, Okinawa, Japan. nigeka@med.u-ryukyu.ac.jp
Asian Cardiovascular & Thoracic Annals
|June 24, 2004
Summary
Aortic dissection can compromise blood flow to abdominal organs. Surgical bypass grafting successfully restored mesenteric artery perfusion and resolved postprandial abdominal pain in a patient with type B aortic dissection.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Gastroenterology
Background:
- Type B aortic dissection can lead to visceral artery complications, including stenosis and malperfusion.
- Abdominal pain, particularly postprandial, can be a symptom of mesenteric ischemia secondary to aortic dissection.
Observation:
- A 63-year-old male presented with back and abdominal pain exacerbated by eating.
- Contrast-enhanced computed tomography confirmed type B aortic dissection.
- Arteriography revealed celiac trunk stenosis and malposition of the superior mesenteric artery in the false lumen.
Findings:
- Surgical intervention involved saphenous vein bypass grafting from the right common iliac artery to the superior mesenteric and gastroduodenal arteries.
- The patient experienced an uneventful postoperative recovery.
Implications:
- Successful revascularization of visceral arteries can effectively treat mesenteric ischemia caused by aortic dissection.
- This case highlights the importance of evaluating visceral artery involvement in type B aortic dissection and considering surgical repair for symptom resolution.