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Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia
An aortic dissection is a condition resulting from a tunica intima tear of the aortic wall creating a ‘false lumen’. An acute Stanford type A (involves the aortic arch and/or ascending aorta) aortic dissection requires emergency surgical repair. To our knowledge, we report the first case in the lite...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613115/ https://www.ncbi.nlm.nih.gov/pubmed/36324767 http://dx.doi.org/10.1093/jscr/rjac480 |
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author | Ahmed-Issap, Amber Balacumaraswami, Lognathen |
author_facet | Ahmed-Issap, Amber Balacumaraswami, Lognathen |
author_sort | Ahmed-Issap, Amber |
collection | PubMed |
description | An aortic dissection is a condition resulting from a tunica intima tear of the aortic wall creating a ‘false lumen’. An acute Stanford type A (involves the aortic arch and/or ascending aorta) aortic dissection requires emergency surgical repair. To our knowledge, we report the first case in the literature where the treatment for an acute type A aortic dissection was intentionally delayed. This was decided following a multidisciplinary team discussion where it was agreed that the patient’s active hepatitis C infection should be treated prior to surgery. The patient re-presented to the hospital 4 months later with acute dyspnoea and orthopnoea where he was diagnosed with an acute-on-chronic type A aortic dissection with trachea compression. This was successfully treated with emergency surgery. However, the patient suffered residual dyspnoea, likely due to phrenic nerve injury demonstrating the impact of untreated aortic arch distension on the neighbouring trachea and phrenic nerve. |
format | Online Article Text |
id | pubmed-9613115 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-96131152022-11-01 Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia Ahmed-Issap, Amber Balacumaraswami, Lognathen J Surg Case Rep Case Report An aortic dissection is a condition resulting from a tunica intima tear of the aortic wall creating a ‘false lumen’. An acute Stanford type A (involves the aortic arch and/or ascending aorta) aortic dissection requires emergency surgical repair. To our knowledge, we report the first case in the literature where the treatment for an acute type A aortic dissection was intentionally delayed. This was decided following a multidisciplinary team discussion where it was agreed that the patient’s active hepatitis C infection should be treated prior to surgery. The patient re-presented to the hospital 4 months later with acute dyspnoea and orthopnoea where he was diagnosed with an acute-on-chronic type A aortic dissection with trachea compression. This was successfully treated with emergency surgery. However, the patient suffered residual dyspnoea, likely due to phrenic nerve injury demonstrating the impact of untreated aortic arch distension on the neighbouring trachea and phrenic nerve. Oxford University Press 2022-10-27 /pmc/articles/PMC9613115/ /pubmed/36324767 http://dx.doi.org/10.1093/jscr/rjac480 Text en Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2022. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Ahmed-Issap, Amber Balacumaraswami, Lognathen Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia |
title | Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia |
title_full | Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia |
title_fullStr | Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia |
title_full_unstemmed | Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia |
title_short | Delayed surgical strategy for type A aortic dissection associated with acute hepatitis C cryoglobulinaemia |
title_sort | delayed surgical strategy for type a aortic dissection associated with acute hepatitis c cryoglobulinaemia |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613115/ https://www.ncbi.nlm.nih.gov/pubmed/36324767 http://dx.doi.org/10.1093/jscr/rjac480 |
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