Open AccessAortic remodeling and competitive flow after surgical treatment of aortic dissection
Author(s) -
Shin Mei Chan,
Anand Brahmandam,
Jonathan Cardella,
John A. Elefteriades,
John F. Setaro,
Abeel A. Mangi,
Cassius Iyad Ochoa Chaar
Publication year - 2021
Publication title -
journal of vascular surgery cases and innovative techniques
Language(s) - English
Resource type - Journals
ISSN - 2468-4287
DOI - 10.1016/j.jvscit.2021.05.009
Subject(s) - medicine , aorta , aortic dissection , dissection (medical) , thrombosis , cardiology , surgery , ischemia
Aortic remodeling after dissection is poorly understood and remains a focus of current research. In the present report, we have described the cases of two patients with acute lower extremity ischemia related to malperfusion from aortic dissection treated with extra-anatomic axillobifemoral bypass. During long-term follow-up, aortic remodeling led to reinstitution of flow through the native aorta. This resulted in competitive flow, leading to complete thrombosis of the extra-anatomic conduits. These cases highlight the occurrence of spontaneous aortic recanalization and subsequent competitive flow, two vascular phenomena that are not well understood but can significantly affect patient outcomes.