Rupture of Acute Triple-Barreled Aortic Dissection

We experienced a case of rupture of acute triple-barreled aortic dissection (AD), a rare form of dissection characterized by the presence of two distinct false lumens in addition to the true lumen, involving a dissecting aneurysm of the descending thoracic aorta (DTA). A 71-year-old woman presented with increasing back pain. She had a history of ascending aortic replacement for type-A acute AD, and there was a residual AD from the aortic arch to the bilateral common iliac arteries. An increasing diameter of the DTA had been observed on follow-up CT scans. At the emergency department, her radial pulses were undetectable and the CT scans revealed rupture of the newly developed false lumen of the DTA. Emergency proximal DTA replacement was performed. Intraoperatively, it was confirmed that the cavity of the DTA had a triple-barreled structure. She had wound infection and aspiration pneumonia on postoperative day (POD) 3 and was treated with antibiotics. However, her postoperative course is generally good, and on POD 31, she waits to be discharged to a rehabilitation hospital.