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Recurrent Pneumothorax With Extensive Subcutaneous Emphysema During the Perioperative Course of Type A Aortic
Qiulin Ran1,2, Zanxin Wang2, Minxin Wei2
1Department of Cardiovascular Surgery Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing China.
Clinical Case Reports
|April 10, 2026
Summary
A young man with acute type A aortic dissection developed recurrent pneumothorax and extensive subcutaneous emphysema after surgery. Prompt recognition and individualized drainage management were crucial for resolution.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pulmonology
Background:
- Acute type A aortic dissection (AoD) is a life-threatening condition requiring emergent surgical repair.
- Perioperative complications, including pneumothorax and subcutaneous emphysema (SE), can arise from the disease and surgical interventions.
Purpose of the Study:
- To report a rare case of extensive perioperative subcutaneous emphysema secondary to recurrent pneumothorax in a patient with acute type A aortic dissection.
- To highlight the multifactorial etiology and management challenges of this complication.
Main Methods:
- Case report of a 29-year-old male with acute type A AoD.
- Description of pre- and post-operative management, including emergency aortic repair and management of recurrent pneumothorax and SE.
- Review of potential contributing factors to air dissection and SE progression.
Main Results:
- The patient developed recurrent pneumothorax and extensive SE postoperatively, despite initial chest drainage.
- Contributing factors identified included persistent coughing, positive-pressure ventilation, venous catheterization, wound air leakage, and mediastinal pleural disruption.
- Subcutaneous emphysema resolved after two weeks of chest tube drainage, with no further pneumothorax recurrence.
Conclusions:
- Perioperative pneumothorax and extensive SE in acute type A aortic dissection patients present unique management challenges.
- Multifactorial etiology necessitates careful consideration of patient-specific factors and iatrogenic influences.
- Prompt recognition, serial imaging, and tailored drainage strategies are essential for successful outcomes.
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