Edorium Journal of

Cardiothoracic and Vascular Surgery

 
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Case Report
 
Catastrophic aortic dissection in a patient of end stage renal disease
Satish Mendonca1, ANM Chengappa2, Devika Gupta3, Sugam Singh4, Pooja Gupta5, V. Ravi Shanker6
1MD (Medicine) DM (Nephrology), Associate Professor Medicine, Armed Forces Medical College and Command Hospital, Pune, India.
2MD (Medicine), Associate Professor Medicine, Armed Forces Medical College and Command Hospital, Pune, India.
3MD, DNB Pathology, Assistant Professor, Armed Forces Medical College, Department of Pathology and Laboratory Science, Command Hospital, Pune, India.
4Resident Medicine, Armed Forces Medical College and Command Hospital, Pune, India.
5MD, DNB Radiodiagnosis, Assistant Professor, Armed Forces Medical College, Department of Radiodiagnosis and Imaging, Pune, India.
6MS, DNB, Mch, FIACS (Cardiothoracic Surgery), Professor Cardiothoracic Surgery, Armed Forces Medical College and Command Hospital, Pune, India.

Article ID: 100006C04SM2015
doi:10.5348/C04-2015-6-CR-5

Address correspondence to:
Satish Mendonca
MD (Medicine) DM (Nephrology), Associate Professor Medicine
Armed Forces Medical College and Command Hospital
Pune - 411040
India
Phone: 09764441405

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How to cite this article
Mendonca S, Chengappa ANM, Gupta D, Singh S, Gupta P, Shanker VR. Catastrophic aortic dissection in a patient of end stage renal disease. Edorium J Cardiothorac Vasc Surg 2015;2:25–29.


Abstract
Introduction: Aortic dissection is a catastrophic condition characterized by a tear in the intimal layer of the aorta leading to splitting of the intima and media forming a false lumen within the aorta. It is a calamitous condition as the blood flow to most of the major branches of the aorta gets compromised. It has a varying presentation and it is described as a great masquerader. Acute aortic dissection is rare, and most cases are discovered during autopsies. The association of aortic dissection with renal failure is high as most patients have coexisting comorbid conditions especially hypertension which is a major risk factor for aortic dissection.
Case Report: We describe a patient on maintenance hemodialysis (MHD) who developed an acute aortic dissection and underwent surgery with a successful outcome which is very rare, even in patients with normal renal function.
Conclusion: Prompt recognition and appropriate intervention is crucial for the survival of the patient. The mortality is very high in thoracic aortic dissection and is estimated to be in hours if emergency surgery is not done.

Keywords: Aortic dissection, Catastrophic condition, End stage renal disease (ESRD), Maintenance hemodialysis


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Author Contributions
Satish Mendonca – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
ANM Chengappa – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Devika Gupta – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sugam Singh – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Pooja Gupta – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
V. Ravi Shanker – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Satish Mendonca et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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