Successful Surgical Treatment of Ruptured Abdominal Aortic Aneurysm Following Stanford Type B Acute Aortic Dissection

(Department of Cardiovascular Surgery, Saiseikai-Shimonoseki General Hospital, Shimonoseki, Japan)

Toshiro Kobayashi Kensuke Sakata Kenji Hayashi
Yurio Kobayashi
A 72-year-old man presented with back pain and 3 days after admission, chest and abdominal CT scanning revealed the existence of infrarenal abdominal aortic aneurysm with Stanford type B acute aortic dissection and hemorrhage in the retroperitoneal space. The maximum diameter of the abdominal aortic aneurysm was 60mm. After treating with anti-hypertensive therapy under restrictive observation because of the patient's stable general condition, surgery was performed 45days after admission. The dissection extended into the abdominal aortic aneurysm and all visceral arteries branched from the true lumen. The presence of thrombus in the preperitoneal space suggested a ruptured abdominal aortic aneurysm. Abdominal aortic aneurysm was replaced with a Y shaped graft and proximal anastomoses was performed with fenestration to prevent rupture of the proximal dissecting aorta. We report a rare case of ruptured abdominal aortic aneurysm following Stanford type B acute aortic dissection, which was operated on in the chronic stage. The patient is doing well.
@Jpn. J. Cardiovasc. Surg. 33: 220-223 (2004)