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Ann Thorac Surg 2006;81:2296-2298
© 2006 The Society of Thoracic Surgeons

Case report

Management of Type A Aortic Dissection and a Large Pheochromocytoma: A Surgical Dilemma

Frank W. Bowen, MD a , * , Jessie Civan, BS a , Anton Orlin, BS a , Thomas Gleason, MD b

a Division of Cardiothoracic Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
b Northwestern Memorial Cardiovascular Institute, Division of Cardiothoracic Surgery, Northwestern University School of Medicine, Chicago, Illinois

Accepted for publication August 12, 2005.

* Address correspondence to Dr Bowen, Department of Cardiothoracic Surgery, 6th Floor Silverstein Pavilion, Hospital of the University of Pennsylvania, 34th and Spruce Streets, Philadelphia, PA 19103 (Email: bowenf{at}uphs.upenn.edu).

The concomitant presence of an undiagnosed pheochromocytoma at the time of an acute type A aortic dissection creates a difficult management dilemma. The case of a patient with an acute type A aortic dissection and pheochromocytoma was stabilized with catecholamine blockade before undergoing ascending aortic and total arch replacement. Fourteen days later the patient underwent resection of the pheochromocytoma. Temporizing medical stabilization of the pheochromocytoma with catecholamine blockade for a period of 5 days allowed for safe aortic reconstruction and seems to be prudent, provided that the aortic dissection remains relatively stable.






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Copyright © 2006 by The Society of Thoracic Surgeons.