J.Jpn. Surg. Soc.. 89(4): 617-621, 1988

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Case report

A RARE CASE OF SUCCESSFUL SURGICAL TREATMENT OF DISSECTING AORTIC ANEURYSM (DeBakey IIIb) ASSOCIATED WITH TOTAL OBSTRUCTION OF THE ABDOMINAL AORTA AND ACUTE COMPLICATED RENAL FAILURE

A rare case of successful surgical management of dissecting aortic aneurysm (DeBakey IIIb) is presented. A fifty-year-old male was admitted to our hospital with a complaint of severe backache and both leg pain. A diagnosis of acute renal failure and assessed total obstruction of the abdominal aorta was made angiographically. Immediate hemodialysis was carried out. After 50 days, a right subclaviafemoral bypass was performed. However, on the 60th postoperative day, plasma creatinine and BUN levels were significantly elevated. A left renal revascularization was performed using saphenous vein graft from the right common iliac artery. The postoperative course was excellent and the creatinine and BUN levels were immediately reduced. And there was no need of hemodialysis postoperatively. Because of difficult management of this kind of complicaton, extra-anatomic bypass is preferable, instead of total replacement of the dissecting aortic aneurysm. And weaning from such a long term hemodialysis by revascularization of one-kidney is very rare.

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