Mária Windisch

A simple surgical method for removing a large floating thrombus from the ascending aorta

We report the successful surgical removal of a large floating thrombus from the ascending aorta causing systemic embolization. It was diagnosed by transesophageal echocardiography (TEE), CT scan, aortography and Cardiovascular Magnetic Resonance Imaging (CMR). The free-floating, highly embolic source 2 cm distal to the left coronary sinus was removed from the ascending aorta using a simple surgical technique. Isolated cerebral perfusion with circulatory arrest on normothermia provided a simple and safe access to the thrombus attached to a ruptured atherosclerotic plaque. The patient was discharged on the 7 th postoperative day after an uneventful recovery.

[Surgical treatment of acute type-B aortic dissection associated with cocaine use].

UNLABELLED Cocaine abuse is on a rise in Hungary as well. It is known that cocaine users have a higher risk developing cardiovascular complications, for example aortic dissection. Almost all patients in Hungary suffering from type B aortic dissection are referred to our department for treatment. AIM We introduce the case of a regular cocaine user, who suffered an acute type B aortic dissection and was treated surgically. To our best knowledge this is the first similar case in our country to be published. METHOD Case presentation. RESULTS We performed a successful operation: acute thoracoabdominal aortic refenestration, no complication was detected. The patient is doing well three months after the procedure, returned to his regular activities, he is normotensively receiving medical treatment, and he gave up cocaine. CONCLUSIONS Thoracoabdominal aortic refenestration can save the life of patients presenting with acute type B dissection. Good long-term result depends on adequate hypertension control and cocaine abstinence. As the frequency of cocaine abuse increases in Hungary, similar cases may be more often encountered.A kokainfogyasztas gyakorisaga Magyarorszagon is novekszik. E drog hasznalata fokozott kockazatot jelent sziv- es errendszeri betegsegek kialakulasa, peldaul aortadissectio szempontjabol. Klinikankon zajlik hazankban a B tipusu aortadissectios betegek dontő tobbsegenek ellatasa. Celkitűzes: Egy rendszeresen kokaint hasznalo, akut B tipusu aortadissectiot elszenvedett beteg műteti kezeleset mutatjuk be esetismertetesunkben, amely tudomasunk szerint az első hasonlo eset hazankban. Modszer: Esetleiras. Eredmenyek: Egy 35 eves ferfi erős, mellkasi-hati-derektaji fajdalmak miatt előszor a gerincsebeszeti osztalyhoz fordult, majd kiugroan magas vernyomasertekek miatt belgyogyaszati osztalyra helyeztek at. A B tipusu aortadissectio diagnozisat CT-angiographia igazolta, a beteg ersebeszeti centrumba kerult, ahol sikeres műtetet, thoracoabdominalis aortarefenesztraciot vegeztunk. A beteg 3 honappal a műtet utan jol van, antihipertenziv szerek szedese mellett mindennapi feladatait ellatja, szovődmenyt nem eszleltunk, a kokainrol leszokott. Kovetkeztetesek: Az akut B tipusu dissectio sebeszi ellatasa megmentheti a beteg eletet. A hosszu tavu eredmenyes kezelesben a hipertonia kontrollja mellett a kokainrol tortenő leszokas alapvető jelentősegű. Hasonlo esetek előfordulasara a kokainfogyasztas novekedese eseten hazankban is szamithatunk.

B típusú aortadissectio sebészi kezelése kokaint használó beteg esetében@@@Surgical treatment of acute type B aortic dissection associated with use of cocaine

UNLABELLED Cocaine abuse is on a rise in Hungary as well. It is known that cocaine users have a higher risk developing cardiovascular complications, for example aortic dissection. Almost all patients in Hungary suffering from type B aortic dissection are referred to our department for treatment. AIM We introduce the case of a regular cocaine user, who suffered an acute type B aortic dissection and was treated surgically. To our best knowledge this is the first similar case in our country to be published. METHOD Case presentation. RESULTS We performed a successful operation: acute thoracoabdominal aortic refenestration, no complication was detected. The patient is doing well three months after the procedure, returned to his regular activities, he is normotensively receiving medical treatment, and he gave up cocaine. CONCLUSIONS Thoracoabdominal aortic refenestration can save the life of patients presenting with acute type B dissection. Good long-term result depends on adequate hypertension control and cocaine abstinence. As the frequency of cocaine abuse increases in Hungary, similar cases may be more often encountered.A kokainfogyasztas gyakorisaga Magyarorszagon is novekszik. E drog hasznalata fokozott kockazatot jelent sziv- es errendszeri betegsegek kialakulasa, peldaul aortadissectio szempontjabol. Klinikankon zajlik hazankban a B tipusu aortadissectios betegek dontő tobbsegenek ellatasa. Celkitűzes: Egy rendszeresen kokaint hasznalo, akut B tipusu aortadissectiot elszenvedett beteg műteti kezeleset mutatjuk be esetismertetesunkben, amely tudomasunk szerint az első hasonlo eset hazankban. Modszer: Esetleiras. Eredmenyek: Egy 35 eves ferfi erős, mellkasi-hati-derektaji fajdalmak miatt előszor a gerincsebeszeti osztalyhoz fordult, majd kiugroan magas vernyomasertekek miatt belgyogyaszati osztalyra helyeztek at. A B tipusu aortadissectio diagnozisat CT-angiographia igazolta, a beteg ersebeszeti centrumba kerult, ahol sikeres műtetet, thoracoabdominalis aortarefenesztraciot vegeztunk. A beteg 3 honappal a műtet utan jol van, antihipertenziv szerek szedese mellett mindennapi feladatait ellatja, szovődmenyt nem eszleltunk, a kokainrol leszokott. Kovetkeztetesek: Az akut B tipusu dissectio sebeszi ellatasa megmentheti a beteg eletet. A hosszu tavu eredmenyes kezelesben a hipertonia kontrollja mellett a kokainrol tortenő leszokas alapvető jelentősegű. Hasonlo esetek előfordulasara a kokainfogyasztas novekedese eseten hazankban is szamithatunk.

Surgical treatment of acute type B aortic dissection associated with use of cocaine

UNLABELLED Cocaine abuse is on a rise in Hungary as well. It is known that cocaine users have a higher risk developing cardiovascular complications, for example aortic dissection. Almost all patients in Hungary suffering from type B aortic dissection are referred to our department for treatment. AIM We introduce the case of a regular cocaine user, who suffered an acute type B aortic dissection and was treated surgically. To our best knowledge this is the first similar case in our country to be published. METHOD Case presentation. RESULTS We performed a successful operation: acute thoracoabdominal aortic refenestration, no complication was detected. The patient is doing well three months after the procedure, returned to his regular activities, he is normotensively receiving medical treatment, and he gave up cocaine. CONCLUSIONS Thoracoabdominal aortic refenestration can save the life of patients presenting with acute type B dissection. Good long-term result depends on adequate hypertension control and cocaine abstinence. As the frequency of cocaine abuse increases in Hungary, similar cases may be more often encountered.A kokainfogyasztas gyakorisaga Magyarorszagon is novekszik. E drog hasznalata fokozott kockazatot jelent sziv- es errendszeri betegsegek kialakulasa, peldaul aortadissectio szempontjabol. Klinikankon zajlik hazankban a B tipusu aortadissectios betegek dontő tobbsegenek ellatasa. Celkitűzes: Egy rendszeresen kokaint hasznalo, akut B tipusu aortadissectiot elszenvedett beteg műteti kezeleset mutatjuk be esetismertetesunkben, amely tudomasunk szerint az első hasonlo eset hazankban. Modszer: Esetleiras. Eredmenyek: Egy 35 eves ferfi erős, mellkasi-hati-derektaji fajdalmak miatt előszor a gerincsebeszeti osztalyhoz fordult, majd kiugroan magas vernyomasertekek miatt belgyogyaszati osztalyra helyeztek at. A B tipusu aortadissectio diagnozisat CT-angiographia igazolta, a beteg ersebeszeti centrumba kerult, ahol sikeres műtetet, thoracoabdominalis aortarefenesztraciot vegeztunk. A beteg 3 honappal a műtet utan jol van, antihipertenziv szerek szedese mellett mindennapi feladatait ellatja, szovődmenyt nem eszleltunk, a kokainrol leszokott. Kovetkeztetesek: Az akut B tipusu dissectio sebeszi ellatasa megmentheti a beteg eletet. A hosszu tavu eredmenyes kezelesben a hipertonia kontrollja mellett a kokainrol tortenő leszokas alapvető jelentősegű. Hasonlo esetek előfordulasara a kokainfogyasztas novekedese eseten hazankban is szamithatunk.

Egyszerű sebészi módszer az aorta ascendensben elhelyezkedő nagy, lebegő thrombus eltávolítására@@@A simple surgical method for removing a large floating thrombus from the ascending aorta

We report the successful surgical removal of a large floating thrombus from the ascending aorta causing systemic embolization. It was diagnosed by transesophageal echocardiography (TEE), CT scan, aortography and Cardiovascular Magnetic Resonance Imaging (CMR). The free-floating, highly embolic source 2 cm distal to the left coronary sinus was removed from the ascending aorta using a simple surgical technique. Isolated cerebral perfusion with circulatory arrest on normothermia provided a simple and safe access to the thrombus attached to a ruptured atherosclerotic plaque. The patient was discharged on the 7 th postoperative day after an uneventful recovery.

Egyszerû sebészi módszer az aorta ascendensben elhelyezkedô nagy, lebegô thrombus eltávolítására

We report the successful surgical removal of a large floating thrombus from the ascending aorta causing systemic embolization. It was diagnosed by transesophageal echocardiography (TEE), CT scan, aortography and Cardiovascular Magnetic Resonance Imaging (CMR). The free-floating, highly embolic source 2 cm distal to the left coronary sinus was removed from the ascending aorta using a simple surgical technique. Isolated cerebral perfusion with circulatory arrest on normothermia provided a simple and safe access to the thrombus attached to a ruptured atherosclerotic plaque. The patient was discharged on the 7 th postoperative day after an uneventful recovery.