THORACOABDOMINAL FENESTRATION FOR AORTIC DISSECTION WITH ISCHEMIC COLONIC PERFORATION

Previous attempts at repair of aortic dissection complicated by intest inal infarction requiring concomitant bowel resection have been fatal. Presented is a case of distal aortic dissection resulting in colonic infarction and perforation. Thoracoabdominal aortic fenestration with concomitant right hemicolectomy was successful. In patients with aorti c dissection complicated by mesenteric ischemia, we recommend urgent g raft replacement of the thoracoabdominal aorta when feasible. When per itoneal contamination precludes the use of prosthetic grafts, thoracoa bdominal fenestration is an effective option.