Emergency descending and abdominal aorta replacement can be an effective treatment for lower limb malperfusion complicated by chronic aortic dissection and bacteremia.
Emergency aortic replacement succeeded in this rare obstructive type B dissection with vegetation; leaves open optimal management of infected aortas.
A 74-year-old man who had been receiving antibiotic treatment for meningitis was transferred to our hospital because of a sudden decrease in lower limb blood pressure. Computed tomography revealed a type B aortic dissection with obstruction of the abdominal aorta. Furthermore, transesophageal echocardiography revealed a large vegetation on the proximal entry tear of the descending aorta. We performed successful emergency descending and abdominal aorta replacement, which prevented complications from intraoperative organ malperfusion. In the present report, we have described an effective treatment for lower limb malperfusion complicated by a combination of chronic aortic dissection and bacteremia.
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Tsujimoto et al. (2022) studied this question.
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