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A Case of Thoracic Endovascular Aortic Repair with Fenestrated Stentgraft for Ulcer-like Projection of the Proximal Anastomosis after Total Arch Replacement for Acute Type A Aortic Dissection after Open Heart Surgery
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（Department of Cardiovascular Surgery, and Department of Radiology*, Kagawa Prefectural Central Hospital, Takamatsu, Japan）
| Shu Yamamoto |
Atsushi Aoki |
Takanori Suezawa |
| Mitsuhisa Kotani |
Mamoru Tago |
Jun Sakurai* |
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We report a case of thoracic endovascular aortic repair（TEVAR）with a fenestrated stent graft for ulcer-like projection（ULP）of the proximal anastomosis after total arch replacement（TAR）for acute type A aortic dissection（DAA). A 73-year-old woman with a history of surgical resection of a left atrial myxoma in January 2009 underwent TAR for DAA in November 2011. The contrast enhanced CT（CE-CT）72 days after TAR revealed two ULPs anterior and posterior to the proximal anastomosis. Surgical repair would be difficult because of the history of cardiac and aortic surgery, therefore TEVAR with a fenestrated stent graft was performed. The postoperative course was uneventful and she was discharged on the 8th postoperative day. The CE-CT 3 months after TEVAR showed almost completely thrombosed ULPs. Endovascular repair with fenestrated stent graft for the proximal anastomotic ULP can be a useful and effective treatment.
Jpn. J. Cardiovasc. Surg. 42:132-136（2013）
Keywords：type A aortic dissection, ulcer-like projection, thoracic endovascular aortic repair, fenestrated stent graft
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