scholarly journals Chronic Type A Aortic Dissection

Aorta ◽  
2016 ◽  
Vol 04 (01) ◽  
pp. 16-21 ◽  
Author(s):  
Conor Hynes ◽  
Michael Greenberg ◽  
Shawn Sarin ◽  
Gregory Trachiotis
Keyword(s):  
Aortic Dissection ◽  
Surgical Repair ◽  
False Lumen ◽  
Disease Process ◽  
Type A ◽  
Delayed Presentation ◽  
Chronic Type ◽  
Type A Aortic Dissection ◽  
First Line Therapy ◽  
Acute Dissection

AbstractStanford Type A aortic dissection is a rapidly progressing disease process that is often fatal without emergent surgical repair. A small proportion of Type A dissections go undiagnosed in the acute phase and are found upon delayed presentation of symptoms or incidentally. These chronic lesions may have a distinct natural history that may have a better prognosis and could potentially be managed differently then those presenting acutely. The method of repair depends on location and extent of the false lumen, as well as involvement of critical structures and branch arteries. Surgical repair techniques similar to those employed for acute dissection management are currently first-line therapy for chronic cases that involve the aortic valve, sinuses of Valsalva, coronary arteries, and supra-aortic branch arteries. In patients with high-risk for surgery, endovascular repairs have been successful, and active development of delivery systems and grafts will continue to enhance outcomes. We present two cases of chronic Type A aortic dissection and review the current literature.

Combined Ascending Aortic Stent-Graft and Inner Branched Arch Device for Type A Aortic Dissection

2018 ◽  
Vol 25 (5) ◽  
pp. 561-565 ◽  
Author(s):  
Yuk Law ◽  
Nikolaos Tsilimparis ◽  
Fiona Rohlffs ◽  
Vladimir Makaloski ◽  
E. Sebastian Debus ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
False Lumen ◽  
Type A ◽  
Type I ◽  
Type A Aortic Dissection ◽  
Landing Zone ◽  
Aortic Stent Graft ◽  
Limited Experience ◽  
Acute Dissection

Purpose: To report the use of the Zenith Ascend stent-graft in conjunction with the Zenith inner branched arch device to treat type A aortic dissection. Case Report: Five patients (mean age 66 years, range 52–78; 4 men) with type A aortic dissection (2 acute) and insufficient distal landing zones were treated with the Zenith Ascend stent-graft and inner branched arch devices to extend the distal landing zone. Left carotid–subclavian bypass was performed in a staged or simultaneous setting depending on the urgency of the condition. Technical success (no type I or III endoleak and successful revascularization of all supra-aortic vessels) was achieved in all patients. Median intensive care unit stay was 5 days (range 4–23) and the median hospital stay was 16 days (range 8–25). The 2 patients with acute dissection died in hospital and at 5 months, respectively. The 3 elective patients were followed for 7, 13, and 19 months, respectively. All had false lumen thrombosis with either a reduced or stable aneurysm diameter. Conclusion: This limited experience demonstrated the feasibility and safety of the combined use of the Ascend stent-graft and inner branched arch devices. This strategy may sometimes be more beneficial than either stent-graft used alone.

False Lumen Catheterization in a Patient Who Has Type A Aortic Dissection That Mimics Acute Inferior Myocardial Infarction: A Case Report

2015 ◽  
Vol 18 (5) ◽  
pp. 208
Author(s):  
Erhan Kaya ◽  
Hakan Fotbolcu ◽  
Zeki Şimşek ◽  
Ömer Işık
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Aortic Dissection ◽  
Cardiac Catheterization ◽  
False Lumen ◽  
Type A ◽  
Inferior Myocardial Infarction ◽  
Type A Aortic Dissection ◽  
Acute Inferior Myocardial Infarction ◽  
Catheterization Procedure

We report a 61-year-old patient who suffered from a type A aortic dissection that mimicked an acute inferior myocardial infarction. During a routine cardiac catheterization procedure, diagnostic catheters can be inserted accidentally into the false lumen. Invasive cardiologists should keep this complication in mind.

Cannulating a Dissecting Aorta Using Ultrasound-Epiaortic and Transesophageal Guidance

2011 ◽  
Vol 14 (6) ◽  
pp. 373 ◽  
Author(s):  
Saina Attaran ◽  
Maria Safar ◽  
Hesham Zayed Saleh ◽  
Mark Field ◽  
Manoj Kuduvalli ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
Complete Rupture

<p>Management of acute Stanford type A aortic dissection remains a major surgical challenge. Directly cannulating the ascending aorta provides a rapid establishment of cardiopulmonary bypass but consists of risks such as complete rupture of the aorta, false lumen cannulation, subsequent malperfusion and propagation of the dissection.</p><p>We describe a technique of cannulating the ascending aorta in patients with acute aortic dissection that can be performed rapidly in hemodynamically unstable patients under ultrasound-epiaortic and transesophageal (TEE) guidance.</p>

Emergent Triple-Branched TEVAR and Redistribution of the Branches to the Supra-Aortic Target Vessels for Treatment of a Contained Ruptured Descending Aortic Aneurysm Associated With a Chronic Type A Aortic Dissection

2021 ◽  
pp. 152660282098527
Author(s):  
Jan Stana ◽  
Carlota Fernandes Prendes ◽  
Ramin Banafsche ◽  
Nikolaos Konstantinou ◽  
Barbara Rantner ◽  
...  
Keyword(s):  
False Lumen ◽  
Type A ◽  
Emergency Setting ◽  
Chronic Type ◽  
Type A Aortic Dissection ◽  
Custom Made ◽  
Descending Aortic Aneurysm ◽  
Type A Dissection ◽  
Open Surgical Approach

Purpose: To demonstrate the feasibility of urgent endovascular treatment of a chronic type A dissection and contained rupture of the false lumen using a noncustomized triple-branched arch endograft, which necessitated reassignment of the branches to the supra-aortic vessels. Case Report:: A 57-year-old patient with a contained rupture of the descending thoracic aorta, in the setting of a chronic type A dissection and a maximum aortic diameter of 85 mm, was converted to endovascular repair after failure of an open surgical approach. A custom-made triple-branched arch endograft designed for another patient was employed, with concomitant occlusion of the false lumen using a Candy Plug occluder. To adjust the graft’s configuration to the patient’s anatomy, the supra-aortic vessels were not assigned to the originally planned branches. The 12-month follow-up angiography demonstrated a satisfactory result. Conclusion: A noncustomized triple-branched arch endograft can be used in an emergency setting to treat chronic type A dissection, reassigning the branches to the supra-aortic vessels as needed.

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