Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair: Incidence, Time Trends and Risk Factors

Background: A 64-year-old woman presented with dilatation of the distal aortic arch secondary to chronic type B aortic dissection. Case Report: The patient underwent fenestrated thoracic endovascular aortic repair (TEVAR) for closure of the entry site, and reconstruction of the left subclavian artery with a covered stent. On the 40th postoperative day, a retrograde type A aortic dissection (RTAD) was observed on computed tomography and she underwent emergency surgery. The entry tear, related to the proximal bare metal stent, was located in front of the aortic arch. A partial aortic arch replacement was performed. Conclusion: Consideration of the risk factors of RTAD is important when performing TEVAR.

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In situ diode laser fenestration of aortic arch stent grafts during thoracic endovascular aortic repair of Stanford type A aortic dissection

EuroIntervention ◽

10.4244/eij-d-18-00710 ◽

2019 ◽

Vol 14 (18) ◽

pp. e1854-e1860 ◽

Cited By ~ 6

Author(s):

Jinbao Qin ◽

Zhen Zhao ◽

Guang Liu ◽

Kaichuang Ye ◽

Minyi Yin ◽

...

Keyword(s):

Aortic Dissection ◽

Aortic Arch ◽

Diode Laser ◽

Type A ◽

Thoracic Endovascular Aortic Repair ◽

Endovascular Aortic Repair ◽

Stent Grafts ◽

Type A Aortic Dissection ◽

Aortic Repair

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Right Axillary Artery Cannulation for Endovascular Repair of an Acute type a Aortic Dissection

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000350 ◽

2017 ◽

Vol 12 (2) ◽

pp. 140-143 ◽

Cited By ~ 1

Author(s):

Corbin E. Muetterties ◽

Jeremy H. Conklin ◽

G. William Moser ◽

Grayson H. Wheatley

Keyword(s):

Aortic Dissection ◽

Endovascular Repair ◽

Axillary Artery ◽

False Lumen ◽

Type A ◽

Thoracic Endovascular Aortic Repair ◽

Endovascular Aortic Repair ◽

Acute Type ◽

Type A Aortic Dissection ◽

Aortic Repair

We present the case of a 48-year-old woman with an acute type A aortic dissection that was treated with thoracic endovascular aortic repair at our institution. The patient was found to have a focal type A dissection with pericardial effusion but no tamponade physiology and no involvement of the aortic valve or root. We elected to treat the patient's type A aortic dissection with an endovascular stent because of the patient's favorable anatomy and no evidence of neurologic deficits or signs of distal malperfusion. The patient was successfully treated with an abdominal aortic cuff deployed through the axillary artery. An axillary approach was necessary because of the short length of the delivery sheath preventing a transfemoral delivery. At 2-year follow-up, the patient remains free of complications with computed tomography scan revealing complete false lumen thrombosis and a stable endovascular repair. This report demonstrates a case of acute type A aortic dissection successfully treated using thoracic endovascular aortic repair and illustrates the utility of axillary cannulation for precise deployment of stent grafts in the ascending aorta.

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