Concomitant Revascularization Using Ascending Aortic Rerouting in Coral Reef Aortic Syndrome
Kengo Tani1, Ryosuke Kowatari1, Norihiro Kondo1
1Department of Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Annals of Vascular Surgery
|November 1, 2019
Summary
Coral reef Aortic Syndrome, a rare condition, can cause severe limb and abdominal pain. Surgical intervention successfully restored blood flow, relieving symptoms in a 72-year-old patient.
Area of Science:
- Vascular Surgery
- Aortic Diseases
- Ischemic Syndromes
Background:
- Coral reef Aortic Syndrome (CRAS) is a severe condition characterized by reduced blood flow to vital organs and lower limbs.
- Early diagnosis and effective treatment are crucial for managing CRAS and preventing complications.
Observation:
- A 72-year-old male presented with postprandial abdominal pain and intermittent claudication, indicative of visceral and lower limb ischemia.
- Computed tomography revealed extensive aortic pathology, including a calcified plaque occluding the thoracoabdominal aorta, celiac axis stenosis, superior mesenteric artery occlusion, and an inferior mesenteric artery aneurysm.
Findings:
- Surgical intervention involved aortic rerouting from the ascending to the infrarenal aorta.
- Reconstruction of the superior mesenteric artery using a saphenous vein graft and direct anastomosis of the inferior mesenteric artery to the aortic bypass were performed.
- The patient experienced complete resolution of ischemic symptoms following the procedure.
Implications:
- This case highlights the successful surgical management of complex aortic disease causing Coral reef Aortic Syndrome.
- The described surgical techniques offer a viable solution for restoring visceral and limb perfusion in patients with extensive aortic pathology.
- Effective treatment of CRAS can significantly improve patient quality of life by alleviating ischemic symptoms.
Related Concept Videos
01:25Aortic Regurgitation III: Medical Management
343
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
343
01:26Aneurysm III: Interprofessional Care
229
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...
229
01:27Coronary Artery Disease V: Interprofessional Care
199
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
199