Author(s):
Hyde Congo, K ; Tomás, A ; Laranjeira, A ; Afonso, D ; Fragata, J
Date: 2018
Persistent ID: http://hdl.handle.net/10400.17/3160
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): HSM CCT; Aneurysm, Dissecting/complications; Aneurysm, Dissecting/surgery; Anticoagulants/therapeutic use; Aorta, Thoracic; Aortic Aneurysm, Thoracic/complications; Aortic Aneurysm, Thoracic/surgery; Blood Vessel Prosthesis Implantation/methods; Chest Pain/etiology; Clinical Decision-Making; Disease Progression; Dyspnea/etiology; Hematoma/etiology; Hematoma/surgery; Pulmonary Embolism/drug therapy; Pulmonary Embolism/etiology; Treatment Outcome
Description
We report the case of 67-year old male patient who was admitted with a 2-week history of progressively worsening chest pain and dyspnea. Diagnostic investigation showed a type B aortic dissection with a retrograde intramural hematoma and bilateral pulmonary embolism. These simultaneous findings highly complicated patient management. Patient was started on anticoagulation therapy with partial resolution of pulmonary embolism after which surgical correction was performed. The patient was successfully submitted to a modified Frozen Elephant Trunk technique with a 3-branched customized Dacron tube and aortic arch replacement with E-Vita Open Plus. Patient post-operative period was uneventful, and he was discharged at the tenth postoperative day. The authors consider this case to be highly unusual regarding the clinical aspects, the challenging decision-making process and the complex surgical approach performed with a favorable outcome.
