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Early superior mesenteric artery revascularization for acute type A aortic dissection with cardiac tamponade and mesenteric malperfusion
  • +3
  • Sho Kusadokoro,
  • Naoyuki Kimura,
  • Kosuke Miyoshi,
  • Daijiro Hori,
  • Manabu Shiraishi,
  • Atsushi Yamaguchi
Sho Kusadokoro
Saitama Medical Center, Jichi Medical University
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Naoyuki Kimura
Saitama Medical Center, Jichi Medical University
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Kosuke Miyoshi
Saitama Medical Center, Jichi Medical University
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Daijiro Hori
Saitama Medical Center, Jichi Medical University
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Manabu Shiraishi
Saitama Medical Center, Jichi Medical University
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Atsushi Yamaguchi
Saitama Medical Center, Jichi Medical University
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Abstract

We report herein successful treatment of a case of acute type A aortic dissection complicated by cardiac tamponade and mesenteric malperfusion. The patient was a 60-year-old man, with back and abdominal pain and in shock, who was transported to our hospital 2 hours after symptom onset. Computed tomography revealed DeBakey type I dissection with massive hemopericardium and obstruction of both the celiac artery and superior mesenteric artery. After emergency pericardiotomy and removal of the hematoma, superior mesenteric artery-external iliac artery bypass was constructed with a vein graft, and this restored mesenteric perfusion. Open distal hemiarch replacement was then performed. The postoperative course was uneventful. Superior mesenteric artery revascularization achieved immediately after release of the cardiac tamponade prevented further mesenteric ischemia and paved the way for the aortic repair.

Peer review status:ACCEPTED

20 Apr 2020Submitted to Journal of Cardiac Surgery
21 Apr 2020Submission Checks Completed
21 Apr 2020Assigned to Editor
22 Apr 2020Reviewer(s) Assigned
30 Apr 2020Review(s) Completed, Editorial Evaluation Pending
07 May 2020Editorial Decision: Revise Major
04 Jun 20201st Revision Received
05 Jun 2020Assigned to Editor
05 Jun 2020Submission Checks Completed
06 Jul 2020Reviewer(s) Assigned
15 Jul 2020Review(s) Completed, Editorial Evaluation Pending
17 Jul 2020Editorial Decision: Revise Minor
03 Aug 20202nd Revision Received
04 Aug 2020Submission Checks Completed
04 Aug 2020Assigned to Editor
25 Aug 2020Reviewer(s) Assigned
26 Aug 2020Review(s) Completed, Editorial Evaluation Pending
26 Aug 2020Editorial Decision: Accept