Surgical aortic fenestration can be successfully performed for intraoperative malperfusion after central repair of acute type A aortic dissection.
May relieve distal malperfusion after central repair in acute type A dissection; leaves open prospective validation.
A 54-year-old man was hospitalized with sudden occurrence of chest and back pains. Computed tomography revealed a thrombus acute type A aortic dissection. Emergency prosthetic graft replacement of the ascending aorta was performed. After completion of the central repair, intraoperative transesophageal echocardiography showed significant narrowing of the true lumen due to the expansion of the false lumen at the level of the descending thoracic aorta. We successfully performed surgical aortic fenestration at the level of the descending thoracic aorta after the reestablishment of cardiopulmonary bypass.
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Hirose et al. (2019) studied this question.
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