Open repair of abdominal aortic dissection. Case report

Introduction

Aortic dissection occurs when the layers of the aortic wall separate as the result of an entrance of blood through a tear in the intima. The mean frequency reported for primary dissection of the abdominal aorta is less than 2%, compared with the ascending aorta (70%), the descending aorta (20%), and the aortic arch (7%).

Clinical case

A 74-year-old man begins his illness with sudden and intense lumbar and abdominal pain. An angiotomography showed an infrarenal abdominal aortic dissection extending to both primitive iliac arteries just before their bifurcation. An aortobifemoral bypass was performed with a bifurcated Dacron graft with a good postoperative result.

Conclusion

Primary abdominal aortic dissection is a rare pathology that in symptomatic patients can be treated with an open or endovascular repair. If the open technique is decided on, excision plus an aortobifemoral bypass can be carried out with good results as in this case.