Key result
Early superior mesenteric artery revascularization after release of cardiac tamponade prevented further mesenteric ischemia and enabled successful aortic repair in acute type A aortic dissection.
Case Report (n=1)
No
Early superior mesenteric artery revascularization immediately following the relief of cardiac tamponade is a viable and successful surgical strategy for acute type A aortic dissection complicated by mesenteric malperfusion.
May support immediate mesenteric revascularization after tamponade relief in select type A dissections; single-case evidence leaves strategy unproven.
We report herein successful treatment of a case of acute type A aortic dissection complicated by cardiac tamponade and mesenteric malperfusion. The patient was a 60-year-old man, with back and abdominal pain and in shock, who was transported to our hospital 2 hours after symptom onset. Computed tomography revealed DeBakey type I dissection with massive hemopericardium and obstruction of both the celiac artery and superior mesenteric artery. After emergency pericardiotomy and removal of the hematoma, superior mesenteric artery-external iliac artery bypass was constructed with a vein graft, and this restored mesenteric perfusion. Open distal hemiarch replacement was then performed. The postoperative course was uneventful. Superior mesenteric artery revascularization achieved immediately after release of the cardiac tamponade prevented further mesenteric ischemia and paved the way for the aortic repair.
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Kusadokoro et al. (2020) conducted a case report in Acute type A aortic dissection with cardiac tamponade and mesenteric malperfusion (n=1). Early superior mesenteric artery revascularization after pericardiotomy was evaluated on Restoration of mesenteric perfusion and successful aortic repair. Early superior mesenteric artery revascularization after release of cardiac tamponade prevented further mesenteric ischemia and enabled successful aortic repair in acute type A aortic dissection.
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