A case of renal cortical necrosis likely caused by disseminated intravascular coagulation after acute type A aortic dissection repair

Acute type A aortic dissection carries a risk of disseminated intravascular coagulation (DIC) due to blood exposure in the false lumen, surgical factors, and false lumen thrombosis. We report the case of a 70-year-old woman who underwent total arch replacement with frozen elephant trunk implantation. Postoperatively, she developed DIC complicated by acute kidney injury and cerebral infarction. Contrast-enhanced computed tomography revealed the reverse rim sign, indicating renal cortical necrosis. Ultimately, irreversible renal failure necessitated maintenance hemodialysis. DIC associated with aortic dissection can lead to multi-organ failure from systemic microthrombosis and requires vigilant monitoring.