Successful surgical correction of ascending aortic dissection in a kidney transplant patient
Cardiovascular disease is the leading cause of death in patients with a transplanted kidney and in graft loss. We present the first clinical case of successful surgical correction of ascending aortic dissection (DeBakey type I) in a young patient with a functioning kidney graft. The patient underwen...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2022-07-01
|
| Series: | Вестник трансплантологии и искусственных органов |
| Subjects: | |
| Online Access: | https://journal.transpl.ru/vtio/article/view/1462 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849338531171794944 |
|---|---|
| author | R. O. Kantaria O. N. Vetchinnikova C. A. Pasov V. A. Dudakov |
| author_facet | R. O. Kantaria O. N. Vetchinnikova C. A. Pasov V. A. Dudakov |
| author_sort | R. O. Kantaria |
| collection | DOAJ |
| description | Cardiovascular disease is the leading cause of death in patients with a transplanted kidney and in graft loss. We present the first clinical case of successful surgical correction of ascending aortic dissection (DeBakey type I) in a young patient with a functioning kidney graft. The patient underwent the first cadaveric kidney transplantation (KTx), which was complicated by acute humoral rejection and suboptimal graft function. High blood pressure, anemia, elevated blood levels of triglycerides, phosphorus, parathyroid hormone, and uric acid were recorded. A repeat KTx was performed five years later; the patient’s condition and kidney function were satisfactory. Three years later,the patient started experiencing severe pain along the thoracic and lumbar spine; his blood creatinine level was 408 μmol/L. Computed tomography and echocardiography diagnosed DeBakey type I aortic dissection (AD) with critical narrowing of the true aortic lumen at certain levels, dissection of aortic branches. Aortic resection surgery with prosthetic replacement of the ascending aorta according to David procedure with reimplantation of coronary artery orifices according to Kouchoukos technique, prosthetic replacement of the aortic arch with debranching of brachiocephalic artery and left common carotid artery were successfully performed as planned under endotracheal anesthesia, cardiopulmonary bypass and selective pharmacological cold cardioplegia. The peculiarities of the course, possible causes and outcomes of surgical correction of thoracic AD in the patient are discussed. |
| format | Article |
| id | doaj-art-38199fb67e3d4172a275485a849e4d13 |
| institution | Kabale University |
| issn | 1995-1191 |
| language | Russian |
| publishDate | 2022-07-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj-art-38199fb67e3d4172a275485a849e4d132025-08-20T03:44:23ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912022-07-0124213414510.15825/1995-1191-2022-2-134-1451093Successful surgical correction of ascending aortic dissection in a kidney transplant patientR. O. Kantaria0O. N. Vetchinnikova1C. A. Pasov2V. A. Dudakov3Vladimirsky Moscow Regional Clinical Research InstituteVladimirsky Moscow Regional Clinical Research InstituteVladimirsky Moscow Regional Clinical Research InstituteVladimirsky Moscow Regional Clinical Research InstituteCardiovascular disease is the leading cause of death in patients with a transplanted kidney and in graft loss. We present the first clinical case of successful surgical correction of ascending aortic dissection (DeBakey type I) in a young patient with a functioning kidney graft. The patient underwent the first cadaveric kidney transplantation (KTx), which was complicated by acute humoral rejection and suboptimal graft function. High blood pressure, anemia, elevated blood levels of triglycerides, phosphorus, parathyroid hormone, and uric acid were recorded. A repeat KTx was performed five years later; the patient’s condition and kidney function were satisfactory. Three years later,the patient started experiencing severe pain along the thoracic and lumbar spine; his blood creatinine level was 408 μmol/L. Computed tomography and echocardiography diagnosed DeBakey type I aortic dissection (AD) with critical narrowing of the true aortic lumen at certain levels, dissection of aortic branches. Aortic resection surgery with prosthetic replacement of the ascending aorta according to David procedure with reimplantation of coronary artery orifices according to Kouchoukos technique, prosthetic replacement of the aortic arch with debranching of brachiocephalic artery and left common carotid artery were successfully performed as planned under endotracheal anesthesia, cardiopulmonary bypass and selective pharmacological cold cardioplegia. The peculiarities of the course, possible causes and outcomes of surgical correction of thoracic AD in the patient are discussed.https://journal.transpl.ru/vtio/article/view/1462kidney transplantationvascular calcificationthoracic aortic dissection (debakey type i)prosthetic ascending aortic replacement |
| spellingShingle | R. O. Kantaria O. N. Vetchinnikova C. A. Pasov V. A. Dudakov Successful surgical correction of ascending aortic dissection in a kidney transplant patient Вестник трансплантологии и искусственных органов kidney transplantation vascular calcification thoracic aortic dissection (debakey type i) prosthetic ascending aortic replacement |
| title | Successful surgical correction of ascending aortic dissection in a kidney transplant patient |
| title_full | Successful surgical correction of ascending aortic dissection in a kidney transplant patient |
| title_fullStr | Successful surgical correction of ascending aortic dissection in a kidney transplant patient |
| title_full_unstemmed | Successful surgical correction of ascending aortic dissection in a kidney transplant patient |
| title_short | Successful surgical correction of ascending aortic dissection in a kidney transplant patient |
| title_sort | successful surgical correction of ascending aortic dissection in a kidney transplant patient |
| topic | kidney transplantation vascular calcification thoracic aortic dissection (debakey type i) prosthetic ascending aortic replacement |
| url | https://journal.transpl.ru/vtio/article/view/1462 |
| work_keys_str_mv | AT rokantaria successfulsurgicalcorrectionofascendingaorticdissectioninakidneytransplantpatient AT onvetchinnikova successfulsurgicalcorrectionofascendingaorticdissectioninakidneytransplantpatient AT capasov successfulsurgicalcorrectionofascendingaorticdissectioninakidneytransplantpatient AT vadudakov successfulsurgicalcorrectionofascendingaorticdissectioninakidneytransplantpatient |