Why the study?
When acute aortic dissection causes malperfusion and the anatomy is not amenable to endovascular strategies, alternative techniques are required.
Case Report (n=2)
No
Open aortic septectomy is a viable alternative for treating malperfusion in complicated type B aortic dissection when endovascular options are not feasible.
Malperfusion is a complication of acute aortic dissection associated with substantially increased morbidity and mortality. Although endovascular treatment of the dissection with a stent graft to cover the intimal tear and reexpand the true lumen will often be sufficient to treat distal malperfusion, persistent or delayed malperfusion will necessitate additional interventions. Endovascular strategies to increase true lumen expansion include bare metal dissection stent placement and percutaneous fenestration. However, for patients with anatomy not amenable to an endovascular approach, alternative techniques are required. We describe two cases of complicated acute aortic dissection due to partial false lumen thrombosis treated with open aortic septectomy. Although an uncommon procedure, open septectomy can be useful for patients with malperfusion syndromes without appropriate endovascular options.
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Lysak et al. (2023) conducted a case report in Complicated acute aortic dissection with malperfusion (n=2). Open aortic septectomy and false lumen thrombectomy was evaluated on Resolution of malperfusion symptoms and restoration of true lumen blood flow.
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