Combined Type B Aortic Dissection and Fusiform Abdominal Aortic Aneurysm

Two patients are described with a combined type B aortic dissection and a fusiform abdominal aortic aneurysm, the dissection not involving the aneurysm. In a seventy- year-old man a type B aortic dissection and a large abdominal aneurysm were found. An infrarenal aortic bifurcation graft was inserted. He died fifteen months later of cardiogenic shock. In a sixty-six-year-old man diagnosis of a primary aortoduodenal fistula was made together with a limited type B dissection. A straight aortic interposi tion graft was inserted. He died eleven months later of the complications of a secondary aortoduodenal fistula.

Although combination of aortic dissection and abdominal aneurysm is a rare occur rence, conservative management of the aortic dissection and interposition graft for the abdominal aneurysm was successful as initial treatment in these 2 patients.