ACUTE DISSECTING ANEURYSMA OF THE AORTA - TYPE B, CASE REPORT

We present a case of a 70-year old man, up to now without any known cardiovascular disease admitted to the cardiology clinic with anamnesis of sudden arisen chest pain propagated into the neck. Based on the anamnesis, physical examination with repeated normal ECG and negative markers of myocardial necrosis, a susspicion of the spontaneus dissection of the aorta was pronounced. CT angiography examination confirmed a diagnosis - dissecting aneurysm of the aorta - type B Standfords classification. Subsequently, at a cardiosurgical clinic, a chest stentgraft was implanted under total anaesthesia / way of a. femoralis/. Nine months after implantation optimal effect of stentgraft persists and the patient is without any limitations in his current life.

Dissecting aneurysm of the aorta poses an urgent, life threatening condition associated with high mortality. A clinical manifestation simulates acute coronary syndrome, it may as well coincide under picture of ischemia of the extremity, or acute aortal regurgitation. In rare cases it may be manifested by hematemesis eventually hemoptysis when perforated the oesophagus, or trachea. Hypotension or shock indicates heart tamponade or bleeding into pleural cavity. Only urgent cardiosurgical intervention leads to decrease of mortality of acute dissection.

Casuistic, as presented by us, introduces an endovaskular treatment of dissecting aneurysm of the aorta - type B Standfords classification, by vascular replacements - stentgrafts, which is an alternative method of surgical treatment for particular patients an the department of the multidisciplinal team of specialists that delivers excellent results.