Staged repair of a ruptured thoracoabdominal aortic aneurysm: a case report

J Cardiothorac Surg. 2024 Apr 15;19(1):212. doi: 10.1186/s13019-024-02703-0.

Abstract

Background: A ruptured thoracoabdominal aortic aneurysm (rTAAA) represents a considerable challenge for surgeons. To date, endovascular procedures have not been able to completely replace open repair when debranching is required.

Case presentation: A 73-year-old man was admitted to our hospital after complaining of left lateral abdominal pain. Enhanced computed tomography revealed a left retroperitoneal hematoma and a large, ruptured Crawford type IV TAAA. We first performed emergency resuscitative surgery to close the lacerated foramen. A graft replacement was performed 1 month after the initial surgery when the patient had stabilized. At 5 years postoperatively, neither occlusion nor anastomotic pseudoaneurysm was noted on computed tomography.

Conclusions: We provide an update on the perioperative management of patients undergoing open rTAAA repair. This procedure can be considered to ensure complete repair of an rTAAA.

Keywords: Case report; Endovascular; Graft replacement; Ruptured aortic aneurysm; Staged repair.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anastomosis, Surgical
  • Aneurysm, False*
  • Aortic Aneurysm, Thoracoabdominal*
  • Aortic Rupture* / diagnostic imaging
  • Aortic Rupture* / surgery
  • Endovascular Procedures*
  • Humans
  • Male