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Type B aortic dissection involving an isolated right-sided aortic arch
P Masiello1, G Mastrogiovanni, G Santoro
1Division of Cardiac Surgery, Hospital S. Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
The Annals of Thoracic Surgery
|September 1, 1996
Summary
A type B aortic dissection in a right aortic arch was successfully treated using a Dacron tube graft. This complex case involved profound hypothermia and cerebral retroperfusion during surgical repair.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Aortic dissection presents a significant surgical challenge, particularly when involving complex aortic arch anatomy.
- Right aortic arch anomalies are rare and can complicate the diagnosis and surgical management of aortic dissections.
Observation:
- A 48-year-old male patient presented with type B aortic dissection involving a right aortic arch and right descending aorta.
- Diagnosis was confirmed using transesophageal echocardiography and computed tomographic (CT) scan, with angiography required for detailed vascular anatomy assessment.
Findings:
- The patient underwent successful surgical repair via a right posterolateral thoracotomy.
- A 24-mm Vascutek Dacron woven tube graft was used for interposition.
- The procedure utilized profound hypothermia with circulatory arrest and cerebral retroperfusion.
Implications:
- This case highlights a successful surgical strategy for managing type B aortic dissection in the rare setting of a right aortic arch.
- The use of cerebral retroperfusion during profound hypothermia may be a viable adjunct in complex aortic arch surgeries.
- This approach offers a potential solution for complex aortic pathologies requiring extensive aortic reconstruction.