A 70-year-old man presented to our hospital for elective descending thoracic aortic aneurysm repair. Four years earlier, the patient had experienced acute aortic dissection of the descending aorta and was effectively treated with tight blood pressure control. This dissection was followed with serial imaging and his aorta slowly expanded to 6.5 cm. The patient reported intermittent back pain, fatigue, and weakness progressing over several months. After extensive discussion with the vascular surgeon and routine cardiopulmonary testing, the patient was brought to the operating room for replacement of his arch and thoracic aorta.
Nabozny MJ, Steffens NM, Schwarze ML. When Do Not Resuscitate Is a Nonchoice ChoiceA Teachable Moment. JAMA Intern Med. 2015;175(9):1444-1445. doi:10.1001/jamainternmed.2015.2326