Repair of Stent Graft-Induced Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair

Akira Katayama	Jun Kawamoto	Hitoshi Tachibana
Miwa Arakawa and Junya Kitaura

（Division of Cardiovascular Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan）

An 80-year-old woman presented with dilatation of the distal aortic arch due to chronic type B aortic dissection. She underwent thoracic endovascular aortic repair（TEVAR）in zone 2 with GORE TAG thoracic endoprostheses（40mm-15cm and 34mm-20cm）for closure of the entry site at the proximal descending aorta. TEVAR was successfully performed and blood flow in the false lumen stopped. Two months after TEVAR, she was admitted to our hospital owing to syncope. A CT scan revealed type A aortic dissection, and emergency surgery was performed. The entry was proximal to the stent graft, and we performed total arch replacement with preservation of the stent graft. Retrograde type A aortic dissection is a rare but lethal complication of TEVAR. Careful consideration of the device selection is needed, and attention should be paid to the placement of the stent graft.

 

Jpn. J. Cardiovasc. Surg. 44:133-136（2015）

Keywords：acute aortic dissection;TEVAR;total arch replacement