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Case Reports
. 2014 Aug 1;2(4):156-60.
doi: 10.12945/j.aorta.2014.14-014. eCollection 2014 Aug.

Hybrid Approach to Repair Type A Aortic Dissection: Combined Endovascular Superior Mesenteric Artery Stenting and Bentall Procedure

Hamoud Y Obied  1 , Ayman Ghoneim  1 , Mohamed F Ibrahim  1
Affiliations
Case Reports

Hybrid Approach to Repair Type A Aortic Dissection: Combined Endovascular Superior Mesenteric Artery Stenting and Bentall Procedure

Hamoud Y Obied et al. Aorta (Stamford). .

Abstract

A Stanford Type A aortic dissection is a life-threatening surgical emergency that requires emergent surgery. The mortality after repair is high especially if the aortic dissection is complicated by visceral or peripheral malperfusion. We describe a case of a male patient who presented with an aortic dissection involving the ascending aorta, aortic arch, descending thoracic aorta, and the abdominal aorta down to the iliac bifurcation. The dissection also involved the visceral and renal arteries with evidence of superior mesenteric artery (SMA) occlusion. Successful outcome was achieved by endovascular stenting of the patient's SMA, followed by a Bentall procedure. To the best of our knowledge this is the first case report in the English literature of SMA stenting followed by a Bentall procedure to treat acute Type A aortic dissection complicated by SMA occlusion.

Keywords: Bentall procedure; Stent graft; Superior mesenteric artery; Type A aortic dissection.

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Figures

Figure 1.
Figure 1.
Computed tomography. A. Preoperative sagittal view showing Type A aortic dissection. B. Axial view showing intimal flap involving the aortic root extending to the descending aorta. C. Axial view showing aortic intimal flap extension to SMA (arrow).
Figure 2.
Figure 2.
A and B. Computed tomography taken 10 days post-repair (A) and showing ascending aorta replacement with valved conduit (B). Note the stent in superior mesenteric artery (SMA). C. Axial view showing the stent in SMA (arrow).
See this image and copyright information in PMC

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