[Single-stage replacement of total aorta for type I dissection with renal failure].

OBJECTIVE

To investigate the feasibility of one-stage replacement of total aorta for patient with renal failure.

METHODS

The patient was male, 43 years old. The type I aortic dissection was secondary to type III aortic dissection 4 months after endovascular treatment of descending aorta using stented graft 1 year ago. All important branches from aorta were irrigated by false lumen of dissection except left renal artery. The patient has been dialyzed because of renal failure before 5 months with low platelets. Single-stage replacement of total aorta from ascending aorta to iliac artery was successful under deep hypothermia and cardiopulmonary bypass. The operation lasted 12 h. Blood loss during operation was 9000 ml and infusion of blood and blood plasma 7300 ml (including 1500 ml of blood retrieval) and blood platelet 800 ml.

RESULTS

Autonomic activity of four limbs was recovered 2 d after operation, and mind recovered 4 d after surgery. The intubation of trachea was extracted 1 week after operation. Re-check through CT showed all vascular prostheses and reconstructed visceral arteries and intercostal arteries were patent though no recovery of renal function.

CONCLUSION

One-stage replacement of total aorta for patient with renal failure is feasible.