Nonoperative Case of Acute Type A Aortic Dissection in a Young Patient.

BACKGROUND: Conservative management of acute type A aortic dissection is challenging but may be necessary in cases of prohibitive surgical risk. CASE SUMMARY: A 33-year-old man with acute type A aortic dissection was ineligible for surgery owing to super obesity (body mass index: 77 kg/m). He was managed medically, planning for surgical intervention after adequate weight loss. During admission, he developed acute respiratory distress syndrome, renal failure requiring dialysis, and gastrointestinal bleeding. The use of semaglutide during acute illness has not been previously reported, but coupled with physical therapy facilitated weight loss. The patient continues making progress 4 months later with a current body mass index of 59 kg/m. DISCUSSION: Multidisciplinary management of conservative treatment of acute type A aortic dissection is necessary to effectively treat severe complications. TAKE-HOME MESSAGE: Semaglutide in settings of acute illness is feasible for facilitating weight loss, and effective conservative management can allow for meaningful recovery in patients with nonoperative acute type A aortic dissection.