scholarly journals Aortic Dissection and Renal Failure in a Patient with Severe Hypothyroidism

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Valerie Brooke ◽  
Sangeeta Goswami ◽  
Arpan Mohanty ◽  
Pashtoon Murtaza Kasi
Keyword(s):  
Renal Failure ◽  
Aortic Dissection ◽  
Early Recognition ◽  
False Lumen ◽  
Uncontrolled Hypertension ◽  
High Morbidity ◽  
Acute Type ◽  
Type B Dissection ◽  
Threatening Condition ◽  
Life Threatening

Acute aortic dissection (AAD) is a life-threatening condition associated with high morbidity and mortality. The most important recognized acquired cause that leads to dissection is chronic arterial hypertension. With respect to the anuria and renal failure, aortic dissection is not something that is always considered and is still not a very common presentation unless both renal arteries come off the false lumen of the dissection. However, when present, preoperative renal failure in patients with acute type B dissection has been noted to be an independent predictor of mortality. Early recognition and diagnosis is the key and as noted by previous studies as well, almost a third of these patients are initially worked up for other causes until later when they are diagnosed with aortic dissection. Here we present a case of a patient presenting with severe hypothyroidism, long-standing hypertension, and anuria. Through the case, we highlight the importance of having aortic dissection as an important differential in patients presenting with anuria who have a long standing history of uncontrolled hypertension. Pathophysiology relating to severe hypothyroidism-induced renal dysfunction is also discussed.

Alcohol Related Non-traumatic Rhabdomyolysis and Compartment Syndrome

2007 ◽  
Vol 6 (1) ◽  
pp. 33-34
Author(s):  
JPL Ong ◽  
◽  
LA Thomas ◽  
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Lower Extremity ◽  
Compartment Syndrome ◽  
Early Recognition ◽  
Clinical Entity ◽  
Threatening Condition ◽  
Life Threatening ◽  
Renal Support

Rhabdomyolysis is a serious and life-threatening condition in which skeletal muscle is damaged, commonly resulting in acute renal failure. The causes of this clinical entity can be traumatic and non-traumatic. In the latter group, alcohol is the commonest cause. This report describes the case of a 25 year old man who presented with rhabdomyolysis leading to acute renal failure after an alcohol binge. He presented with painful legs and lower extremity compartment syndrome. The patient recovered with surgical fasciotomy and renal support. This case illustrates the importance of early recognition and treatment of alcohol related non-traumatic rhabdomyolysis and compartment syndrome.

scholarly journals Acute Aortic Dissection Mimicking STEMI in the Catheterization Laboratory: Early Recognition Is Mandatory

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Alessio Arrivi ◽  
Gaetano Tanzilli ◽  
Paolo Emilio Puddu ◽  
Giovanni Truscelli ◽  
Marcello Dominici ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Early Recognition ◽  
Type A ◽  
Type A Aortic Dissection ◽  
Catheterization Laboratory ◽  
Arterial Complication ◽  
Threatening Condition ◽  
Life Threatening ◽  
Previously Treated ◽  
Pathophysiologic Mechanisms

Coronary malperfusion due to type A aortic dissection is a life-threatening condition where timely recognition and treatment are mandatory. A 77-year-old woman underwent an acute evolving type A aortic dissection mimicking acute myocardial infarction. Two pathophysiologic mechanisms are discussed: either thrombosis migrating from a previously treated giant aneurism of proximal left anterior descending or a local arterial complication due to left main stenting. Recognition of these occurrences in the catheterization laboratory is important to look immediately for surgery.

scholarly journals Localized Aortic Dissection in a Patient with Polycystic Kidney Disease: A Case Report

2021 ◽  
Vol 6 (04) ◽  
pp. 285-287
Author(s):  
Sarah A. Alkuraydis ◽  
Abdulaziz S. Allihimy ◽  
Osama Smettei ◽  
Rami M Abazid
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Acute Chest Pain ◽  
Uncontrolled Hypertension ◽  
Polycystic Kidney ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
Multiple Cysts

Aortic dissection (AD) is the most frequent life-threatening aortic disorder. It is commonly associated with hypertension; however, aortic dissection occasionally represents a complication of more complex syndromes. In this article we aim to report. A 40-year-old male patient, with a known case of ADPKD and a strong family history of ADPKD. He presented to the emergency department with prolonged sharp retrosternal chest pain radiating to the back and uncontrolled hypertension. Computed tomography angiography showed a localized dissection flap at the aortic root and multiple cysts in the right kidney. AD is a life-threatening condition and should be suspected in patients presenting with acute chest pain with history of ADPKD.

Aortic root replacement in a patient with previous coronary artery bypass

2021 ◽  
pp. 021849232199738
Author(s):  
Juan F Parra ◽  
Eric E Vinck ◽  
Jessica N González ◽  
Hernando Santos
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Type A ◽  
Composite Graft ◽  
Acute Type ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening

Acute type A thoracic aortic dissection is a life-threatening condition that requires rapid diagnosis and prompt surgical intervention. Prior cardiac surgery is recognized as a predisposing risk factor. Here, we report a rare case and successful surgical repair of a late presenting acute type A thoracic aortic dissection four years after a three-vessel coronary artery bypass grafting. Resection of the aortic valve and aneurysmal tissue was required, reconstruction was done with a composite graft, and the native coronary ostia and aorto-saphenous buttons were preserved.

scholarly journals Hybrid Stepwise External Wrapping for Type A Acute Aortic Dissection with Cerebral Malperfusion

2020 ◽  
Author(s):  
Yoshihiro Suematsu ◽  
Satoshi Nishi ◽  
Daisuke Arima ◽  
Akihiro Yoshimoto
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Aortic Rupture ◽  
False Lumen ◽  
Type A ◽  
Good Physical Condition ◽  
Threatening Condition ◽  
Valve Insufficiency ◽  
Life Threatening ◽  
Cerebral Malperfusion

Abstract Background: Acute aortic dissection (AAD) is a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A AAD (TAAAD) still remains high, and treatment for such patients remains controversial. We report a successful treatment of TAAAD with a communicating false lumen in a 60-year-old man with acute hemi-cerebral malperfusion. Case presentation: The ascending aorta was wrapped with stepwise external wrapping (SEW) procedure, and subsequent thoracic endovascular aortic repair (TEVAR) was successfully performed. The patient was discharged in good physical condition without any complications. Conclusions: Hybrid therapy with SEW and TEVAR with TAAAD associated with major cerebral malperfusion should be considered, especially in patients for whom open surgery is extremely risky.

scholarly journals Hybrid Strategy for Residual Arch and Thoracic Aortic Dissection following Acute Type A Aortic Dissection Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Sidharth Viswanathan ◽  
Vivek Agrawal ◽  
Shashidhar Kallappa Parameshwarappa ◽  
Ajay Savlania ◽  
Santhosh Kumar ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Circulatory Arrest ◽  
Management Strategies ◽  
False Lumen ◽  
Type A ◽  
High Morbidity ◽  
Acute Type ◽  
Hybrid Strategy ◽  
Type A Aortic Dissection ◽  
Thoracic Aortic Dissection

Progressive dilatation of the false lumen in the arch and descending aorta has been encountered in one-third of survivors as a late sequelae following repair of ascending aortic dissection. Conventional treatment for the same requiring cardiopulmonary bypass and deep hypothermic circulatory arrest is associated with high morbidity and mortality especially in the elderly cohort of patients. Herein we report a case of symptomatic progressive aneurysmal dilatation of residual arch and descending thoracic aortic dissection following repair of type A aortic dissection, successfully treated by total arch debranching and ascending aortic prosthesis to bicarotid and left subclavian bypass followed by staged retrograde aortic stent-graft deployment. This case report with relevant review of the literature highlights this clinical entity and the present evidence on its appropriate management strategies. Close surveillance is mandatory following surgical repair of type A aortic dissection and hybrid endovascular procedures seem to be the most dependable modality for salvage of patients detected to have progression of residual arch dissection.

scholarly journals Intraoperative Transesophageal Echocardiography in Management of Acute Type I Aortic Dissection With Malperfusion: A Case Report

2021 ◽  
Author(s):  
Kaitlin E Beyrau ◽  
Huckelberry A Finne ◽  
Sara M Wilson ◽  
Steven L Gibson ◽  
Erin E Koelling ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Transesophageal Echocardiography ◽  
Intraoperative Imaging ◽  
Critical Role ◽  
False Lumen ◽  
Type I ◽  
Acute Type ◽  
Life Saving ◽  
Intraoperative Transesophageal Echocardiography ◽  
Life Threatening

ABSTRACT Acute type I aortic dissection is a life-threatening emergency with potentially devastating complications, including end-organ malperfusion. Early detection of malperfusion with intraoperative imaging allows for efficient transition to appropriate interventions. We present a case of a 65-year-old male with acute type I aortic dissection who underwent emergent surgical repair of the aortic root and hemiarch followed by acutely worsening distal malperfusion. The use of intraoperative transesophageal echocardiography played a critical role in visualizing diversion of flow to the false lumen, prompting urgent vascular surgery consultation and life-saving thoracic endovascular aortic repair.

scholarly journals Role of Echocardiography as Supporting Diagnostic Modality in Localized Stanford Type A Aortic Dissection

2016 ◽  
pp. 285-95
Author(s):  
Haris Munirwan ◽  
Amiliana Mardiani Soesanto ◽  
Rina Ariani ◽  
Taofan Taofan ◽  
Suko Adiarto ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
High Morbidity ◽  
Diagnostic Modality ◽  
Type A Aortic Dissection ◽  
Aortic Pathology ◽  
Acute Aortic Syndromes ◽  
Threatening Condition ◽  
Life Threatening

Ascending Stanford type A aortic dissection carries a high morbidity and mortality. Proper identification of the proximal origin of the dissection and determination of concomitant aortic valve involvement significantly facilitate surgical repair which may improve survival.2Rapid imaging is necessary for the timely diagnosis of a potentially life-threatening condition. Transthoracic Echocardiography is highly accurate for the detection of acute aortic syndromes especially identify ascending aortic pathology such as type A aortic dissection.3 We report the unusual case of 52-years old male who present atypical presentation of aortic dissection with unclear view of dissection by CT Angiography aorta, and diagnosed as Localized Stanford A Aortic dissection with supported data by echocardiography modality.

scholarly journals Hybrid Stepwise External Wrapping for Type A Acute Aortic Dissection with Cerebral Malperfusion

2020 ◽  
Author(s):  
Yoshihiro Suematsu ◽  
Satoshi Nishi ◽  
Daisuke Arima ◽  
Akihiro Yoshimoto
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Aortic Rupture ◽  
False Lumen ◽  
Type A ◽  
Good Physical Condition ◽  
Threatening Condition ◽  
Valve Insufficiency ◽  
Life Threatening ◽  
Cerebral Malperfusion

Abstract Background: Acute aortic dissection (AAD) is a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A AAD (TAAAD) still remains high, and treatment for such patients remains controversial. We report a successful treatment of TAAAD with a communicating false lumen in a 60-year-old man with acute hemi-cerebral malperfusion. Case presentation: The ascending aorta was wrapped with stepwise external wrapping (SEW) procedure, and subsequent thoracic endovascular aortic repair (TEVAR) was successfully performed. The patient was discharged in good physical condition without any complications. Conclusions: Hybrid therapy with SEW and TEVAR with TAAAD associated with major cerebral malperfusion should be considered, especially in patients for whom open surgery is extremely risky.

Ultrasound diagnosis of dissecting thoracic aortic aneurysms: procedure with a handheld device and a video-illustrated case

2021 ◽  
Vol 51 (1) ◽  
pp. 10-15
Author(s):  
Kenneth V Iserson ◽  
Sri Devi Jagjit ◽  
Balram Doodnauth
Keyword(s):  
Aortic Dissection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
Handheld Device ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Handheld Ultrasound

Acute thoracic aortic dissection is an uncommon, although not rare, life-threatening condition. With protean signs and symptoms that often suggest more common cardiac or pulmonary conditions, it can be difficult to diagnose. Ultrasound has proven useful in making the correct diagnosis. This case demonstrates that training gained using standard ultrasound machines can be easily and successfully adapted to newer handheld ultrasound devices. The examination technique using the handheld device is illustrated with photos and a video.

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