Type B Aortic Dissection with Retrograde Intramural Hematoma and Pulmonary Embolism

Hyde Congo, K; Tomás, A; Laranjeira, A; Afonso, D; Fragata, J

http://hdl.handle.net/10400.17/3160

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Abstract(s)

We report the case of 67-year old male patient who was admitted with a 2-week history of progressively worsening chest pain and dyspnea. Diagnostic investigation showed a type B aortic dissection with a retrograde intramural hematoma and bilateral pulmonary embolism. These simultaneous findings highly complicated patient management. Patient was started on anticoagulation therapy with partial resolution of pulmonary embolism after which surgical correction was performed. The patient was successfully submitted to a modified Frozen Elephant Trunk technique with a 3-branched customized Dacron tube and aortic arch replacement with E-Vita Open Plus. Patient post-operative period was uneventful, and he was discharged at the tenth postoperative day. The authors consider this case to be highly unusual regarding the clinical aspects, the challenging decision-making process and the complex surgical approach performed with a favorable outcome.

Keywords

HSM CCT Aneurysm, Dissecting/complications Aneurysm, Dissecting/surgery Anticoagulants/therapeutic use Aorta, Thoracic Aortic Aneurysm, Thoracic/complications Aortic Aneurysm, Thoracic/surgery Blood Vessel Prosthesis Implantation/methods Chest Pain/etiology Clinical Decision-Making Disease Progression Dyspnea/etiology Hematoma/etiology Hematoma/surgery Pulmonary Embolism/drug therapy Pulmonary Embolism/etiology Treatment Outcome