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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Related Experiment Video

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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Iatrogenic subintimal aortic dissection that disappeared without a trace.

Kazumasa Orihashi1, Kazuki Kihara1, Masaki Yamamoto1

  • 1Division of Cardiovascular Surgery, Second Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Japan.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|May 9, 2017
PubMed
Summary

An unusual iatrogenic aortic dissection, termed vanishing aortic dissection, was observed during surgery. Promptly switching perfusion strategy resolved the dissection, highlighting the need for careful intraoperative aortic monitoring.

Keywords:
Aortic dissectionCardiopulmonary bypassIntraoperative complication

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Medicine
  • Medical Imaging

Background:

  • Acute type A aortic dissection requires emergency surgical intervention.
  • Iatrogenic complications can arise during complex cardiovascular procedures.
  • Systemic perfusion strategies are critical in aortic surgery.

Observation:

  • A 77-year-old male with acute type A aortic dissection developed a secondary dissection during femoral artery perfusion.
  • Transesophageal echocardiography revealed an unusual, thin flap in the descending aorta.
  • The secondary dissection resolved upon switching to antegrade perfusion.

Findings:

  • The secondary dissection appeared to be subintimal in origin.
  • The "vanishing" nature of the dissection was attributed to perfusion technique.
  • No malperfusion or aortic rupture occurred after the perfusion strategy change.

Implications:

  • Careful intraoperative monitoring of the aorta is crucial to detect transient dissections.
  • Failure to identify such "vanishing" dissections could lead to unexplained organ damage.
  • This case highlights a rare iatrogenic complication and its management.