The "TEVAR-first" approach to DeBakey I aortic dissection with mesenteric malperfusion

Bradley G Leshnower; Ravi K Veeraswamy; Yazan M Duwayri; Edward P Chen

doi:10.1016/j.athoracsur.2013.06.110

The "TEVAR-first" approach to DeBakey I aortic dissection with mesenteric malperfusion

Ann Thorac Surg. 2014 Feb;97(2):693-6. doi: 10.1016/j.athoracsur.2013.06.110.

Authors

Bradley G Leshnower¹, Ravi K Veeraswamy², Yazan M Duwayri², Edward P Chen³

Affiliations

¹ Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia. Electronic address: [email protected].
² Division of Vascular Surgery and Endovascular Therapy, Emory University School of Medicine, Atlanta, Georgia.
³ Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia.

PMID: 24484813
DOI: 10.1016/j.athoracsur.2013.06.110

Abstract

Acute DeBakey type 1 aortic dissection presenting with mesenteric malperfusion is a lethal variant of all dissection-related malperfusion syndromes with reported mortality rates of 38% to 75%. Conventional surgical treatment involves proximal aortic replacement to restore true lumen perfusion, followed by mesenteric revascularization if malperfusion persists. In an attempt to improve the dismal outcomes associated with this malperfusion syndrome, we have instituted a [thoracic endovascular aortic repair] "TEVAR-First" approach in hemodynamically stable patients, which allows for earlier true lumen expansion and resolution of the malperfusion syndrome.

Keywords: 26.

Publication types

Case Reports

MeSH terms

Aortic Aneurysm, Thoracic / classification
Aortic Aneurysm, Thoracic / physiopathology*
Aortic Aneurysm, Thoracic / surgery*
Aortic Dissection / classification
Aortic Dissection / physiopathology*
Aortic Dissection / surgery*
Endovascular Procedures / methods*
Female
Humans
Middle Aged
Splanchnic Circulation*
Thoracic Surgical Procedures