Successful surgical repair of acute DeBakey type I aortic dissection complicated by acute occlusion of the suprarenal abdominal aorta

We reported a case of acute DeBakey type I aortic dissection presented with occlusion of the suprarenal abdominal aorta, who was successfully treated by simultaneous graft replacement of the ascending aorta and total aortic arch. The patient was a 68-year-old man who complained of chest pain and symptoms of acute arterial occlusion of bilateral lower extremities, and who had consciousness disturbance due to stroke caused by aortic dissection. He underwent simultaneous graft replacement of the ascending aorta and total aortic arch under selective cerebral perfusion during an emergent operation. For reconstruction of the arch vessels, we used three separate grafts that were connected to the aortic prosthesis before use. Although postoperative course was complicated by myonephropathic metabolic syndrome, the patient subsequently recovered and was discharged on foot. Early vascular reconstruction and appropriate management of reperfusion injury are extremely important in the setting of malperfusion phenomena complicating acute aortic dissection.