SAGE Open Medical Case Reports (Jun 2021)

Successfully superior mesenteric artery stenting in operated type A aortic dissection complicated with delayed mesenteric malperfusion

  • Roxana Carmen Geana,
  • Platon Pavel,
  • Reza Nayyerani,
  • Iulia Kulcsar,
  • Adrian Tulin,
  • Oana Honciuc,
  • Irina Balescu,
  • Nicolae Bacalbasa,
  • Ovidiu Stiru,
  • Vlad Anton Iliescu,
  • Catalina Andreea Parasca

DOI
https://doi.org/10.1177/2050313X211021184
Journal volume & issue
Vol. 9

Abstract

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Here, we describe a case of a 61-year-old male patient with acute type A aortic dissection involving the ascending aorta, aortic arch, descending aorta, and the abdominal aorta down to the iliac bifurcation with evidence of left common iliac artery occlusion. Computed tomography angiography revealed progressive dissection into the superior mesenteric artery and left renal artery with no clinical signs of mesenteric ischemia. Emergent ascending aortic reconstruction of the dissected aorta relieves the leg ischemia. On a postoperative day 9, the evolution was complicated by massive right hemothorax. Although the patient was hemodynamically stable after obtaining hemostasis, the patient developed paralytic ileus with a high elevated lactate level. Visceral malperfusion was not detected by exploratory laparotomy. Emergency abdominal aortic angiography revealed superior mesenteric artery intermittent occlusion, successfully treated by stenting implantation.