A Case of Partial Arch and Descending Aortic Replacement for a Ruptured Type B Acute Aortic Dissection

(Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan and Present address:Department of Cardiovascular Surgery, Kitasato University School of Medicine*, Sagamihara, Japan)

Ko Shibata* Haruo Makuuchi Toshiya Kobayashi
Masahide Chikada Hirosi Murakami Takamaro Suzuki
Hirokuni Ono Kiyoshi Chiba , Tokuichiro Nagata
Ruptured type B acute aortic dissection(AAD)is a life-threatening condition, in which surgical treatment most often yields unsatisfactory results. We report a case of a ruptured type B AAD in a 67-year-old man detected on computed tomography that required a partial aortic arch replacement with reconstruction of the left subclavian artery with adjunct deep hypothermic circulatory arrest(DHCA). Although the patient had a postoperative stroke, he recovered markedly with rehabilitation. DHCA and open proximal anastomosis are useful for the surgical treatment of type B AAD, however, an elaborate strategy to prevent an intraoperative cerebral embolism is especially important.
  Jpn. J. Cardiovasc. Surg. 38:64-66(2009)