J.Jpn. Surg. Soc.. 83(5): 439-445, 1982

---

Original article

ABDOMINAL AORTIC RESECTION WITH FENESTRATION IN THORACIC DISSECTION

Dissection nearly always begins in the thorax, but it commonly extends into abdominal aorta, which may become the focal point of the disease. We present two patients with the focal point in the abdominal aorta as a result of thoracic dissections which were DeBakey type IIIb.
Patient-a 57-year-old man, was admitted to the hospital as an emergency case, with progressive lumbago, abdominal pain and hypertension, which persisted despite vigorus drug therapy such as Reserpin and Trichlormethiazide. Hypertension was barely controled by Arfonad administration. The other-a 63-year old man, had a pulsative abdominal mass without hypertension and left hemiplegia due to apoplexy one year ago.
Both patients had an aortic bifurcation graft with reentry of the false lumen at the infrarenal level after removing the tongue of intima, which separated the true and false lumen. The false lumen communicated into the left iliac artery in the first patient and the right internal iliac artery in the second patient. After the abdominal aortic reconstruction, hypertension in the first patient was controlled successfully by Reserpine. Both patients well 8 to 22 months after surgery.
Though the resection of distal aorta with a reentry procedure after removing the tongue of intima is palliative surgery for thoracic dissection, this method may be an appropriate therapy when aortic dissection extends into the abdomen and the patients are poor risks.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.