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Endograft and external cinch to control hemorrhage in acute type A aortic dissection
Author(s) -
Tenali Aalekhya,
Arnaoutakis Dean J.,
Martin Tomas D.,
Beaver Thomas M.,
Arnaoutakis George J.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14475
Subject(s) - medicine , aortic dissection , aortic arch , surgery , thoracic aorta , descending aorta , hemostasis , ductus arteriosus , dissection (medical) , cardiopulmonary bypass , cardiology , aorta
Acute DeBakey I or II aortic dissection (AD) is a surgical emergency with significant mortality if not repaired immediately. We present the case of a 49‐year‐old man with acute type I AD, who initially underwent zone 2 arch replacement for a primary arch tear. A calcified ductus arteriosus was noted during arch reconstruction. He exhibited exsanguinating hemorrhage from the proximal descending thoracic aorta upon an initial attempt to wean off cardiopulmonary bypass. Hemostasis was achieved with retrograde transfemoral thoracic endovascular aortic repair and transmediastinal external cinch around the descending aorta to obliterate false lumen flow.