What a coincidence: Episodes of acute aortic dissections occurred in cousins with sleep apnea syndrome within a week
Zhong Gao Wang, Yong Quan Gu, Jian Zhang, Jian Xin Li, Hen Xi Yu
CaseRepClinPractRev 2005; 6:5-8
Background: Acute aortic dissection is the mot catastrophic entity occurring in the aorta. The occlusive sleep apnea syndrome (OSAS) is a respiratory disorder. Two consecutive cases that were cousins with OSAS in whom attacks of acute aortic dissection occurred within a week. They had also obesity and hypertension without Marfan’s syndrome.
Case report: Case I was a male patient, 35-year-old, admitted because of a sudden attack of an acute severe and intolerable back pain. The patient had hypertension and a heavy snoring. Diagnosis of
OSAS had been made by polysomnography. His body weight was 100 kg; height 170 cm. A Stanford B aortic dissection was diagnosed by CT and MRI. On Jan 2, 2004, an endograft was successfully deployed at the beginning of the descending aorta, the tear to the false lumen
was completely sealed. On the 3rd postoperative day, the patient developed diarrhea and abdominal fullness, after an angiography, an immediate laparotomy was performed, and majority of the intestine colored blue-purple was found. an iliac – superior mesenteric artery
(SMA) bypass with PTFE graft solved the crisis. Case II, aged 45, the cousin of the previous patient, admitted to the hospital because of a sudden onset of a severe back pain after a heavy labor. He had hypertension for 3 years with a heavy snoring, his AHI (Apnea hypopnea index)was 30, diagnosis of OSAS could be made, his weight was 102 kg and height 169 cm. CT and MRI led to the diagnosis of aortic dissection with its tear located in the descending
aorta 3 cm below the orifice of the left subclavian artery. On Jan 5, 2004, endografting was successfully performed and the postoperative recovery was uneventfully. Both patients resumed to normal life.
Conclusions: The relation between the acute aortic dissection and the OSAS was disclosed; the factors, such as family link, hypertension and obesity, as etiological factors of aortic dissection, seems worthy for further studying.
Keywords: Aortic dissection, occlusive sleep apnea syndrome, endograft