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...

Full description

Saved in:
Bibliographic Details
Main Authors: Einar Dregelid, Alireza Daryapeyma
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Vascular Medicine
Online Access:http://dx.doi.org/10.1155/2013/978625
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849691763733692416
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