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Eur J Cardiothorac Surg 1999;15:91-94
© 1999 Elsevier Science NL

Case report

Percutaneous fenestration of the aortic dissection membrane in malperfusion syndrome

^a Department of Cardiothoracic Surgery, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
^b Department of Radiology, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany

Received 2 June 1998; received in revised form 26 October 1998; accepted 2 November 1998.

Corresponding author. Tel.: +49-941-944-9810; fax:+49-941-944-9802; e-mail: delawer.reber@klinik.uni-regensburg.de

We present two cases of malperfusion syndrome due to aortic dissection type-B. A supra-renal blind sac phenomenon resulted in renal failure and absent femoral pulses in both patients. Additionally, one patient suffered from spinal cord ischemia, the other from severe abdominal pain. By interventional techniques, catheter perforation of the blind sac was achieved. The resulting re-entries were enlarged with a balloon catheter. Distal perfusion without pressure gradients was restored by this technique in both patients and resulted in complete relief of symptoms. Percutaneous fenestration of the aortic dissection membrane may be an alternative to operative treatment in malperfusion syndrome.

Key Words: Aortic dissection • Malperfusion syndrome • Percutaneous fenestration

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