Delayed Surgical Management of Acute Type A Aortic Dissection in a Patient with Recent COVID-19 Infection and Post-COVID-19 Bronchopneumonia—Case Report and Review of Literature

Ever since it was first described in 1760, acute type A aortic dissection has created difficulties in its management. The recent COVID-19 pandemic revealed that extrapulmonary manifestations of this condition may occur, and recent reports suggested that aortic dissection may be amongst them since it...

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Published in:Medicina (Kaunas, Lithuania) Lithuania), 2022-09, Vol.58 (10), p.1357
Main Authors: Robu, Mircea, Marian, Diana Romina, Vasile, Rasvan, Radulescu, Bogdan, Stegaru, Alice, Voica, Cristian, Nica, Claudia, Gheorghita, Daniela, Zaharia, Ondin, Iulian, Antoniac, Moldovan, Angelica, Pavel, Victor, Moldovan, Horatiu, Iliescu, Vlad Anton
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Aortic dissection
Blood pressure
Blood vessels
Bronchopneumonia
cardiopulmonary bypass
Care and treatment
Carotid arteries
Case Report
Case reports
Case studies
Coronary vessels
Coronaviruses
COVID-19
Creatinine
Dissecting aneurysm
Edema
Ejection fraction
Infections
Intensive care
Ischemia
malperfusion syndrome
Medical imaging
Oxygen saturation
Patients
Respiratory failure
Severe acute respiratory syndrome coronavirus 2
Surgery
type A aortic dissection
Ultrasonic imaging
Veins & arteries
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Summary:Ever since it was first described in 1760, acute type A aortic dissection has created difficulties in its management. The recent COVID-19 pandemic revealed that extrapulmonary manifestations of this condition may occur, and recent reports suggested that aortic dissection may be amongst them since it shares a common physiopathology, that is, hyper-inflammatory syndrome. Cardiac surgery with cardiopulmonary bypass in the setting of COVID-19-positive patients carries a high risk of postoperative respiratory failure. While the vast majority accept that management of type A aortic dissection requires urgent surgery and central aortic therapy, there are some reports that advocate for delaying surgery. In this situation, the risk of aortic rupture must be balanced with the possible benefits of delaying urgent surgery. We present a case of acute type A dissection with COVID-19-associated bronchopneumonia successfully managed after delaying surgery for 6 days.
ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina58101357