A Case of Traumatic Retrograde Type A Aortic Dissection Accompanied by Multiorgan Injuries

Tsukioka, Katsuaki; Kono, Tetsuya; Takahashi, Kohei; Kehara, Hiromu; Urashita, Shuichi; Komatsu, Kotaro

doi:10.3400/avd.cr.17-00033

Cited by 8 publications

(7 citation statements)

References 9 publications

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“…A surgical approach requiring CPB can be applied only in limited cases because BAI is often associated with active bleeding from multiple injuries [2] . A previous case report demonstrated the clinical course of a patient with retrograde type A aortic dissection who underwent delayed total aortic arch replacement with CPB [4] . This report showed successful outcomes through delayed surgery after confirming that hemostasis had occurred at other injury sites.…”

Section: Discussionmentioning

confidence: 99%

Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma

Nagashima¹,

Sugiyama²,

Kondo³

et al. 2022

Trauma Case Reports

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A 53-year-old man underwent thoracic endovascular aortic repair for persistent false lumen perfusion and limb salvage because of type A aortic dissection, severe lower-limb ischemia, and bleeding (mediastinal hematoma, bilateral lung contusion, liver injury, and splenic injury) caused by blunt trauma. We embolized the left supreme intercostal artery to control active mediastinal hemorrhage. Acute hemorrhage and leg ischemia were well controlled; however, residual blood flow in the false lumen persisted. We performed a Zone 2 thoracic endovascular aortic repair and discharged the patient on day 67. Thoracic endovascular aortic repair is a practical option for treating traumatic type A dissection.

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Section: Discussionmentioning

confidence: 99%

Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma

Nagashima¹,

Sugiyama²,

Kondo³

et al. 2022

Trauma Case Reports

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“…However, the prognosis of TAI may be catastrophic. It is reported that more than 75% of TAI patients die before they are transferred to a medical center, and more than half of the remaining patients die within 24 hours [ 6 ]. The main causes of early death in patients with TAI include insufficient tissue perfusion and hemodynamic instability [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Early Clinical Diagnosis and Treatment of Traumatic Aortic Injury Caused by Thoracic and Abdominal Injuries: A Series of Four Cases with Literature Review

Sun

Xie

et al. 2021

BioMed Research International

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Aortic injury, particularly traumatic aortic dissection caused by thoracic and abdominal injuries, is extremely rare. The diagnosis rate of blunt aortic injury caused by chest and abdominal injuries is often low, and its clinical manifestations are atypical. Once missed or misdiagnosed, the consequences are serious. Early diagnosis of traumatic aortic injury in complex thoracic and abdominal injuries is a key factor in reducing the mortality of trauma patients. Among all trauma patients treated in our department from December 2018 to December 2020, we diagnosed four cases of aortic injury, including three cases of aortic dissection and one case of intramural hematoma. Successful surgical treatment and clinical outcome were achieved in all four patients. We found that early diagnosis and surgical treatment can help to reduce the mortality of patients with traumatic aortic injury and improve the prognosis.

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“…Specifically, ascending aorta is usually not involved without direct hit on the chest or rapid deceleration. 4,10 In addition, she never presented with any chest and back pain previously, and she had never been diagnosed with an aortic dissections. Therefore, we cannot confirm whether this was a newly developed dissection or a worsening intrinsic subclinical dissection.…”

Section: Discussionmentioning

confidence: 99%

<p>A Case of Fatal Stanford Type A Aortic Dissection Caused by a Traffic Accident with Low Energy Impact</p>

Mori

Otomo

2020

OAEM

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A seemingly healthy 84-year-old female pedestrian was mildly bumped by a car, and she hit her left shoulder, flank, and lower legs when she fell down on a street. She was conscious and stable when transferred to an emergency room. She had no sign of any major injuries except minor lacerations on her legs. Repeated evaluations including chest X-ray, ECG, and focused assessment with sonography for trauma did not reveal any abnormal findings. While waiting for discharge, she started having mild chest discomfort. Unexpectedly, the third echocardiogram showed mild pericardial effusion, and a CT with contrast showed aortic dissection in the ascending aorta and infra-left subclavian aortic dissection. She was immediately transferred by a helicopter to a tertiary trauma center for emergent repair surgery. Considering the site of dissections, progression of existing intrinsic intimal tear triggered by energy impact was suspected. However, traumatic causes could not be excluded. Extra caution and diligence should be exercised when examining elderly patients in blunt trauma.

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A Case of Traumatic Retrograde Type A Aortic Dissection Accompanied by Multiorgan Injuries

Cited by 8 publications

References 9 publications

Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma

Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma

Early Clinical Diagnosis and Treatment of Traumatic Aortic Injury Caused by Thoracic and Abdominal Injuries: A Series of Four Cases with Literature Review

<p>A Case of Fatal Stanford Type A Aortic Dissection Caused by a Traffic Accident with Low Energy Impact</p>

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