Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal Outcome
Case reports to analyze causes and possible prevention of complications in a new setting are important. We present an open repair of a ruptured type 2 thoracoabdominal aortic aneurysm in a 78-year-old man. Lower-body perfusion through a temporary extracorporeal axillobifemoral arterial prosthesis sh...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/978625 |
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| author | Einar Dregelid Alireza Daryapeyma |
| author_facet | Einar Dregelid Alireza Daryapeyma |
| author_sort | Einar Dregelid |
| collection | DOAJ |
| description | Case reports to analyze causes and possible prevention of complications in a new setting are important. We present an open repair of a ruptured type 2 thoracoabdominal aortic aneurysm in a 78-year-old man. Lower-body perfusion through a temporary extracorporeal axillobifemoral arterial prosthesis shunt was combined with the use of a branch to the permanent aortic prosthesis to enable rapid visceral revascularization using a visceral-anastomosis-first approach. The patient died due to transfusion-induced capillary leak syndrome and left colon necrosis; the latter was probably caused by a combination of back-bleeding from lumbar arteries causing a steal effect, an accidental shunt obstruction, and hemodynamic instability towards the end of the operation. The visceral-anastomosis-first approach did not contribute to the complications. This approach reduces the time when visceral organs are perfused only via collateral arteries to the time needed for suturing the visceral anastomoses. This may be important when collateral perfusion is marginal. |
| format | Article |
| id | doaj-art-b644d8116f464dda8b58ab26e91c6bef |
| institution | DOAJ |
| issn | 2090-6986 2090-6994 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Vascular Medicine |
| spelling | doaj-art-b644d8116f464dda8b58ab26e91c6bef2025-08-20T03:20:55ZengWileyCase Reports in Vascular Medicine2090-69862090-69942013-01-01201310.1155/2013/978625978625Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal OutcomeEinar Dregelid0Alireza Daryapeyma1Department of Vascular Surgery, Haukeland University Hospital, Jonas Lies Vei 65, 5021 Bergen, NorwayDepartment of Vascular Surgery, Karolinska University Hospital, 171 76 Stockholm, SwedenCase reports to analyze causes and possible prevention of complications in a new setting are important. We present an open repair of a ruptured type 2 thoracoabdominal aortic aneurysm in a 78-year-old man. Lower-body perfusion through a temporary extracorporeal axillobifemoral arterial prosthesis shunt was combined with the use of a branch to the permanent aortic prosthesis to enable rapid visceral revascularization using a visceral-anastomosis-first approach. The patient died due to transfusion-induced capillary leak syndrome and left colon necrosis; the latter was probably caused by a combination of back-bleeding from lumbar arteries causing a steal effect, an accidental shunt obstruction, and hemodynamic instability towards the end of the operation. The visceral-anastomosis-first approach did not contribute to the complications. This approach reduces the time when visceral organs are perfused only via collateral arteries to the time needed for suturing the visceral anastomoses. This may be important when collateral perfusion is marginal.http://dx.doi.org/10.1155/2013/978625 |
| spellingShingle | Einar Dregelid Alireza Daryapeyma Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal Outcome Case Reports in Vascular Medicine |
| title | Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal Outcome |
| title_full | Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal Outcome |
| title_fullStr | Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal Outcome |
| title_full_unstemmed | Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal Outcome |
| title_short | Novel Visceral-Anastomosis-First Approach in Open Repair of a Ruptured Type 2 Thoracoabdominal Aortic Aneurysm: Causes behind a Mortal Outcome |
| title_sort | novel visceral anastomosis first approach in open repair of a ruptured type 2 thoracoabdominal aortic aneurysm causes behind a mortal outcome |
| url | http://dx.doi.org/10.1155/2013/978625 |
| work_keys_str_mv | AT einardregelid novelvisceralanastomosisfirstapproachinopenrepairofarupturedtype2thoracoabdominalaorticaneurysmcausesbehindamortaloutcome AT alirezadaryapeyma novelvisceralanastomosisfirstapproachinopenrepairofarupturedtype2thoracoabdominalaorticaneurysmcausesbehindamortaloutcome |