Two Cases of Endovascular Repair with the Stent Graft for Retrograde Type A Acute Aortic Dissection with Complications

Ann Thorac Cardiovasc Surg. 2019 Oct 20;25(5):278-282. doi: 10.5761/atcs.cr.17-00200. Epub 2018 Mar 3.

Abstract

Thoracic endovascular aortic repair (TEVAR) is used to treat retrograde type A acute aortic dissection (RTAAD). In case 1, a 52-year-old man, who was conservatively managed, reported worsening back pain. Emergency TEVAR was performed 7 days after onset. After deploying two GORE Conformable TAG (CTAG) in the descending aorta, his symptoms disappeared. In case 2, a 52-year-old man with progressive worsening resistant hypertension, renal dysfunction, and respiratory failure despite maximal medical therapy underwent TEVAR 8 days after onset. A CTAG was deployed from the left subclavian artery under rapid pacing, and two Zenith Dissection stents were placed, which resolved complications. In both cases, after 6 months, computed tomography (CT) scan showed complete resorption of the false lumen in the ascending aorta. TEVAR for RTAAD with complete thrombosis of false lumen in the ascending aorta can be an alternative to surgery when the primary tear is located in descending aorta.

Keywords: Type A acute aortic dissection; retrograde type A aortic dissection; thoracic endovascular aortic repair (TEVAR).

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / physiopathology
  • Aorta, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / physiopathology
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / physiopathology
  • Aortic Dissection / surgery*
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endovascular Procedures / instrumentation*
  • Humans
  • Male
  • Middle Aged
  • Stents*
  • Treatment Outcome