Bail-out Visceral Bypass Grafting for Acute Intestinal Ischemia after Endovascular Stent-Graft Placement in a Complicated Type B Dissection

Abstract

We report on the case of a 35-year-old male who underwent emergency stent-graft placement in March 2007 due to a complicated type B dissection. One week after this procedure the patient developed critical visceral malperfusion. Subsequently, autologous iliaco-mesenteric as well as iliaco-hepatic bypass grafting was performed. At 6-month follow-up, aortic remodelling has occurred and visceral perfusion is regular.

Aortic disease - cardiovascular surgery - heart disease

References

• 1 Eggebrecht H, Nienaber C A, Neuhauser M. et al . Endovascular stent-graft placement in aortic dissection: a meta-analysis.  Eur H J. 2006;  27 489-498
• 2 Trimarchi S, Nienaber C A, Rampoldi V. et al . Role and results of surgery in acute type B aortic dissection: insights from the international registry of acute aortic dissection (IRAD).  Circulation. 2006;  114 (Suppl 1) I357-I364
• 3 Reber D, Aebert H, Manke M, Birnbaum D E. Percutaneous fenestration of the aortic dissection membrane in malperfusion syndrome.  Eur J Cardiothorac Surg. 1999;  15 91-94
• 4 Gottardi R, Zimpfer D, Holzenbein T. et al . Extraanatomic visceral bypass for consecutive endovascular treatment of a thoracoabdominal aortic aneurysm.  Eur J Vasc Endovasc Surg. 2006;  31 564
• 5 Vogt P R, Brunner-La Rocca H P, Carrel T. et al . Cryopreserved vascular allograft in the treatment of major vascular infection: a comparison with conventional surgical techniques.  J Thorac Cardiovasc Surg. 1998;  116 965-972
• 6 Böckler D, Schumacher H, Klemm K. et al . Hybrid procedures as a combined endovascular and open approach for pararenal and thoracoabdominal aortic pathologies.  Langenbecks Arch Surg. 2007;  392 (6) 715-723