Work

Surgical Management of Type A Aortic Intramural Hematoma With Cerebral Malperfusion: Carotid Revascularization and Arch Replacement

Year: 2025

Type: article

Abstract: Acute type A aortic dissection (ATAAD) with cerebral malperfusion presents a significant surgical challenge. This report describes a novel approach involving initial right carotid artery repair with interposition grafting and selective cerebral perfusion, followed by total aortic arch replacement using deep hypothermic circulatory arrest. This strategy optimized cerebral perfusion and facilitated successful aortic repair. The patient experienced partial neurologic recovery despite an initial ischemic stroke with hemorrhagic conversion. This case highlights the importance of a tailored, multidisciplinary approach in patients with complex ATAAD.

Source: Annals of Thoracic Surgery Short Reports

DOI: 10.1016/j.atssr.2025.04.012

Authors: Susana Fortich, Jose I. Ortiz De Elguea-Lizarraga, Junji Tsukagoshi, Mitchell W. Cox, Andre Y. Son, Abe DeAnda

Institution: The University of Texas Medical Branch at Galveston

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $975