CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 6, July 2013
AFRICA
e3
placement of a Dacron graft, although resection of the affected
aorta with end-to-end anastomosis without graft insertion has
been described.
9
This decision is greatly influenced by anatomical
conditions together with the surgeon’s experience. It is unclear
what benefit endovascular stenting would have in the treatment
of IMH.
8
The fragile tissue makes suturing of the vascular
prosthesis to the vascular wall difficult. Bleeding from the aortic
anastomosis may lead to uncontrollable bleeding and even death.
A new vascular ring connector (Vasoring, Sunwei Technology
Co, Taipei, Taiwan) has been designed for aortic dissections.
3
In the series of Wei and co-workers,
10
the VRC may improve
mid-term results of aortic dissection by reducing both the
anastomosis time and the risk of bleeding.
The VRC is composed of a biocompatible titanium alloy
that has two grooves on the outside of the VRC.
3
The device is
inserted into a vascular prosthesis to form an intraluminal graft
and is fixed against the narrow groove with a non-absorbable
suture. The narrow groove is designed for better external
fixation. Then braided tape, tied around the overlapping region of
the abdominal aorta and the VRC at the wider groove, provides
a sutureless anastomosis and homogenous contact surface. The
time of anastomosis is shorter than with conventional surgery.
We used the VRC for the first time in this case of the IMH
that progressed to dissected abdominal aorta. The results provide
evidence that the VRC is a promising method of treatment for
IMH of the abdominal aorta progressing to rupture.
Conclusion
Aortic IMH is a difficult diagnosis that requires a high index of
suspicion. The vascular ring connector may improve the results
of aortic dissection by reducing both the anastomosis time and
the risk of bleeding. It is an alternative method for the treatment
of dissected abdominal aorta.
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