TITLE:
Thoracic Endovascular Aortic Repair for Cardiopulmonary Arrest Due to Aortic Dissection
AUTHORS:
Yoshiro Kikuoka, Naoki Fujimura, Yu Michiura, Tomohiro Kamagata, Yumi Tsuchiya, Shiho Irino, Motojiro Takebe, Yoko Sugawara, Satoshi Ohtsubo, Kazuhiko Sekine
KEYWORDS:
Acute Aortic Dissection, Cardiac Tamponade, Cardiopulmonary Arrest on Arrival, Retrograde Stanford Type A Aortic Dissection, r-TAAD, Thoracic Endovascular Aortic Repair, TEVAR
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.10 No.11,
November
17,
2021
ABSTRACT: Background and Aim: Reports on recovery from Stanford type A aortic dissection (TAAD) leading to cardiopulmonary arrest (CPA) are few. In retrograde TAAD (r-TAAD) cases, some authors reported the efficacy of thoracic endovascular aortic repair (TEVAR). However, only a few reports chose TEVAR for the treatment of r-TAAD resulting in cardiac arrest before hospital arrival. We report a case of r-TAAD presenting with cardiac arrest before hospital arrival not indicated for surgery but TEVAR as treatment. Case: A 65-year-old woman with a history of Marfan syndrome presented to the emergency department after a CPA. Sequential return of spontaneous circulation was achieved 27 min after CPA. Contrast-enhanced computed tomography showed retrograde r-TAAD with an entry tear to the false lumen in the thoracic descending aorta. Therefore, thoracic endovascular aortic repair (TEVAR) was performed with r-TAAD. Afterward, the clinical course was stabilized. This patient suggests that TEVAR is an effective option for the treatment of patients with hemodynamically unstable r-TAAD, even after CPA. Conclusion: TEVAR can lead to a successful recovery from cardiac arrest due to r-TAAD.