Abdominal aortic resection in thoracic dissection
J. A. Hunter, W. S. Dye, H. Javid, H. Najafi, M. D. Goldin and C. Serry
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.
