Key result
A multi-site perfusion strategy combined with a Hybrid Frozen Elephant Trunk graft successfully restored cerebral circulation and minimized permanent neurological damage in a patient with acute type A aortic dissection.
Why the study?
Acute type A dissection with cerebral malperfusion carries high morbidity and mortality, presenting complex vascular challenges where surgery often requires difficult aortic arch and neck vessel reconstruction.
Case Report (n=1)
No
Aggressive arch and neck vessel reconstruction supported by multi-site perfusion can successfully restore cerebral circulation in acute type A aortic dissection complicated by cerebral malperfusion.
Acute type A dissection with cerebral malperfusion may still allow surgery in select cases; leaves open optimal strategies for this high-risk presentation.
Acute type A dissection presenting with cerebral malperfusion has high morbidity and mortality. Given the complexity of underlying vascular involvement, it is a challenging clinical scenario. Many of these patients are not deemed surgical candidates. If surgery is considered, it often requires complex aortic arch and neck vessel reconstruction. We present a 48-year-old male with an acute type A aortic dissection that presented with paraplegia and decreased level of consciousness. A Computed Tomography showed occlusion of both common carotid arteries. He was successfully treated with a multi-site perfusion strategy and a Hybrid Frozen Elephant Trunk graft to achieve fast restoration of the cerebral circulation and minimize brain ischemia and permanent neurological damage. From this case, we learn that aggressive arch and neck vessel reconstruction supported by multi-site perfusion could help improve mortality and neurological outcomes in selected patients.
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Besa et al. (2023) conducted a case report in Acute type A aortic dissection complicated with cerebral malperfusion (n=1). Multi-site perfusion strategy and Hybrid Frozen Elephant Trunk (FET) graft was evaluated on Survival and neurological recovery. A multi-site perfusion strategy combined with a Hybrid Frozen Elephant Trunk graft successfully restored cerebral circulation and minimized permanent neurological damage in a patient with acute type A aortic dissection.
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