Surgical management of complicated Stanford type A aortic dissection with subdural haematoma due to constrictive pericarditis -a case report

Weibo He¹Dongmei Sun²Shiyuan Yao¹Yuan Wu^1*Linglin Fan^1*

• ¹Department of Cardiac Surgery, Yue Bei People’s Hospital of Shantou University, Shantou University Medical College, Shaoguan, China, Shaoguan, China
• ²Department of oncology, Yue Bei People’s Hospital of Shantou University, Shantou University Medical College, Shaoguan, China, Shaoguan, China

Constrictive pericarditis, often resulting from pericardial adhesions secondary to chest radiotherapy or cardiac surgery, generally carries a favorable prognosis when surgical intervention is performed early. In contrast, extensive acute aortic dissection is associated with a significantly higher mortality rate, highlighting the critical importance of timely surgical intervention to improve patient outcomes. Here, we present a case involving a patient with a ruptured Stanford type A aortic dissection complicated by constrictive pericarditis, which led to the formation of a large pseudoaneurysm causing severe compression of the right atrium and markedly increasing the risk of mortality.The patient underwent successful emergency one-stage surgery and was discharged with a favorable recovery. This report uniquely highlights the management of two lifethreatening conditions-type A aortic dissection and constrictive pericarditis-in a single surgical procedure, aiming to enhance patient survival and minimize complications. This case not only illustrates a successful life-saving intervention but also provides a strategic framework for cardiac surgeons, encouraging them to address complex, high-risk cases with an integrated approach.