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Jean M. Panneton, MD, Swee H. Teh, MD, Kenneth J. Cherry, MD, Jan M

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Presentation on theme: "Jean M. Panneton, MD, Swee H. Teh, MD, Kenneth J. Cherry, MD, Jan M"— Presentation transcript:

1 Aortic fenestration for acute or chronic aortic dissection: An uncommon but effective procedure 
Jean M. Panneton, MD, Swee H. Teh, MD, Kenneth J. Cherry, MD, Jan M. Hofer, RN, BSN, Peter Gloviczki, MD, James C. Andrews, MDa, Thomas C. Bower, MD, Peter C. Pairolero, MD, John W. Hallett, MD  Journal of Vascular Surgery  Volume 32, Issue 4, Pages (October 2000) DOI: /mva Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

2 Fig. 1 CT of the abdomen showing a left-sided crescent-shaped true lumen compressed by the false lumen, with decreased perfusion to the superior mesenteric artery. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

3 Fig. 2 Schematic drawing of aortic fenestration showing infrarenal aortic transection with cephalad pararenal aortotomy and resection of the septum between the false and true lumens (left). After pararenal fenestration, infrarenal aortic replacement with an aortobi-iliac graft (top right) or primary closure without graft replacement (bottom right). Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

4 Fig. 3 Injections with the catheter in the false (A) and true (B) lumens show the left renal, celiac, and superior mesenteric arteries to arise from the true lumen, and the two right renal arteries to arise from the false lumen. A pressure gradient >30 mm Hg was measured from the false to the true lumen. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

5 Fig. 4 Fenestration was performed with the balloon advanced across the septum from the true to the false lumen (inset) at the level of the renal arteries (A). A Palmaz stent was placed in the true lumen at the level of the celiac and opened to 12 mm to hold the aortic wall away from the visceral vessel origins. Completion angiogram (B) shows excellent perfusion of both lumens through the fenestration, with a gradient of 7 mm Hg from the false to the true lumen. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

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