Clinical Case Database / Category: Patient Management

Acute type B aortic dissection

Publication details

Veeru Kasivisvanathan MBBS BSc (Hons), MRCS, House Officer, Romesh Sarvanandan MBBS BSc (Hons), MRCS, House Officer, Matthew J Metcalfe MD, FRCS, SpR Vascular Surgery, Daniel T M Fascia MBChB BSc (Hons) MRCS, SpR Radiology, Michael P Jenkins BSc MS FRCS FEBVS, Consultant Vascular Surgeon
Foundation Years Journal, volume 5, issue 1, p.12 (123Doc Education, London, February 2011)

Abstract

A 71-year-old lady presented to the accident and emergency department with severe sternal chest pain radiating to the back and a cold pulseless left leg. A computer tomography scan confirmed a Type B aortic dissection (AD) with an occluded left external iliac artery. She underwent urgent thoracic endovascular aortic repair (TEVAR) with the placement of a stent graft, which restored blood flow to the true lumen. The patient suffered no post-operative complications.

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Authors

Veeru Kasivisvanathan MBBS BSc (Hons), MRCS, House Officer

St Mary’s Vascular Unit, St Mary’s Hospital, Praed Street, Paddington, W2 1NY

Romesh Sarvanandan MBBS BSc (Hons), MRCS, House Officer

St Mary’s Vascular Unit, St Mary’s Hospital, Praed Street, Paddington, W2 1NY

Matthew J Metcalfe MD, FRCS, SpR Vascular Surgery

St Mary’s Vascular Unit, St Mary’s Hospital, Praed Street, Paddington, W2 1NY

Daniel T M Fascia MBChB BSc (Hons) MRCS, SpR Radiology

Radiology department, St Mary’s Hospital, Praed Street, Paddington, W2 1NY

Michael P Jenkins BSc MS FRCS FEBVS, Consultant Vascular Surgeon

St Mary’s Vascular Unit, St Mary’s Hospital, Praed Street, Paddington, W2 1NY

References

(1) Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): New insights into an old disease. JAMA. 2000;283(7):897–903.
(2) Nienaber CA, Ince H, Weber F, et al. Emergency stent-graft placement in thoracic aortic dissection and evolving rupture. J Card Surg 2003;18(5):464–70.
(3) Beregi J, Haulon S, Otal P, et al. Endovascular Treatment of Acute Complications Associated With Aortic Dissection: Midterm Results From a Multicenter Study. J Endovasc Ther. 2003;10(3):486–93.
(4) Siegal EM. Acute aortic dissection. J Hosp Med 2006;1(2):94–105.
(5) Moore AG, Eagle KA, Bruckman D, et al. Choice of computed tomography, transesophageal echocardiography, magnetic resonance imaging, and aortography in acute aortic dissection: International Registry of Acute Aortic Dissection (IRAD). Am J Cardiol 2002;89(10):1235–38.
(6) Ince H, Nienaber CA. Diagnosis and management of patients with aortic dissection. Heart. 2007;93(2):266–70.
(7) Chiappini B, Schepens M, Tan E, et al. Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients. Eur Heart J 2005;26(2):180–86.
(8) Estrera AL, Miller CC, III, Safi HJ, et al. Outcomes of Medical Management of Acute Type B Aortic Dissection. Circulation. 2006;114(1 Suppl):I-384–389.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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