[Thoracic aortic dissection complicating autosomal dominant polycystic kidney disease; report of a case]

Abstract

A 55-year-old man underwent aortic valve replacement for aortic valve insufficiency 12 years ago. At that time, autosomal dominant polycystic kidney disease was diagnosed. Subsequently, renal failure developed gradually. In August 2007, the patient was admitted to the hospital because of dull back pain. Computed tomography (CT) revealed aortic dissection extending from the ascending aorta to the bifurcation of the iliac artery (Stanford type A). However, the patient had no severe symptoms associated with aortic dissection On the basis of the results of CT and blood testing, chronic aortic dissection was diagnosed. Because the patient also had chronic renal failure we decided to perform elective surgery. In January 2008, ascending aortic and aortic arch replacement with a distal elephant trunk was performed. After surgery, we were concerned about the risk of renal failure. However, the patient recovered uneventfully, without requiring dialysis. Aortic dissection can occur as a complication in patients with autosomal dominant polycystic kidney. Strict control of blood pressure is therefore essential in such patients.