Acute Stanford type B aortic dissection with rapid expansion associated with coarctation of the aorta and Turner syndrome: A case report

Introduction: Turner syndrome is the most common established cause of aortic dissection in young women. These patients usually have associated Stanford type A aortic dissection. We present herein a case of acute type B aortic dissection complicated by coarctation of the aorta and Turner syndrome, an exceptionally rare pathological combination. Case presentation: A 40-year-old woman with Turner syndrome experienced sudden back pain. Enhanced computed tomography revealed coarctation, type B dissection, and a descending aortic aneurysm with a size of 33 mm. The dissecting aneurysm rapidly expanded; therefore, we performed descending aorta replacement with coarctectomy through a left posterolateral thoracotomy. Arterial cannulas were placed on the ascending aorta and the right femoral artery to provide sufficient cerebral perfusion. To prevent paraplegia, we performed open proximal and distal aortic anastomosis in deep hypothermic cardiac arrest. The postoperative course was uneventful. Conclusions: The success of this surgery depended on selecting the appropriate approach, establishing extracorporeal circulation with adequate blood return, and applying the necessary supportive measures. Clinicians should maintain a high index of suspicion for aortic aneurysm or dissection in patients with Turner syndrome.