Key result
Endovascular repair successfully resolves recurrent malperfusion and seals false lumen in iatrogenic type B dissection.
Why the study?
Management strategies for intraoperative iatrogenic type B aortic dissection during ascending aorta replacement are not well established.
Case Report (n=1)
Endovascular repair can be a successful definitive treatment for iatrogenic type B aortic dissection complicated by malperfusion syndrome following ascending aorta replacement.
Endovascular repair may succeed in iatrogenic type B dissection with malperfusion; hypothesis-generating, larger studies needed before adoption.
We present the case of a 74-year-old female patient with a 50 mm ascending aortic aneurysm who underwent ascending aorta replacement. During routine open heart surgery, suboptimal flow in the cardiopulmonary bypass circuit, led to the discovery of a type B aortic dissection with substantial flow in the false lumen. Conservative management was chosen, focusing on blood pressure control in the ICU. Despite an initial uneventful recovery the patient developed malperfusion syndrome prompting consideration of endovascular repair. Following a temporary improvement, malperfusion symptoms recurred, leading to a successful endovascular repair, with complete thrombosis of the false lumen.
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Pavlopoulos et al. (2025) conducted a case report in Intraoperative iatrogenic type B aortic dissection (n=1). Endovascular repair was evaluated on Resolution of malperfusion syndrome and thrombosis of the false lumen. Endovascular repair successfully treated recurrent malperfusion syndrome and achieved complete thrombosis of the false lumen in a patient with intraoperative iatrogenic type B aortic dissection.
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