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Abdominal Aortic Resection in Thoracic Dissection
James A. Hunter, MD;
William S. Dye, MD;
Hushang Javid, MD;
Hassan Najafi, MD;
Marshall D. Goldin, MD;
Cyrus Serry, MD
Arch Surg. 1976;111(11):1258-1262.
Abstract
• Dissection nearly always begins in the thorax, but it commonly extends into the abdominal aorta, which may become the focal point of the disease. We report five patients who illustrate the surgical management of this disease variant.
Clinical manifestations included retroperitoneal rupture, expanding false aneurysm, and lower aortic occlusion. All patients had an aortic bifurcation graft, with reentry of the false lumen at the renal level. Two patients also had thoracic-aortic resection or plasty or both. Although one patient had thoracic aortic rupture at the five-year interval, these abdominal aortic resections provided effective palliation in all. This successful experience in managing complex dissections shows that when aortic dissection extends into the abdomen, resection of the distal aorta with a reentry procedure may be appropriate therapy.
(Arch Surg 111:1258-1262, 1976)
Author Affiliations
From the Department of Cardiovascular-Thoracic Surgery, Rush Medical College and Rush Presbyterian-St Luke's Medical Center, Chicago.
Footnotes
Accepted for publication July 9, 1976.
Read before the 24th scientific meeting of the International Cardiovascular Society, Albuquerque, NM, June 19, 1976.
Reprint requests to 1725 W Harrison St, Suite 850, Chicago, IL 60612 (Dr Hunter).
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