Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair in a Patient with Bovine Aortic Arch

Keiichi Ishida＊	Hirono Satokawa＊	Shinya Takase＊
Yoshiyuki Sato＊	Yuki Seto＊	Takashi Igarashi＊
Akihiro Yamamoto＊	Tsuyoshi Fujimiya＊	Hitoshi Yokoyama＊

（Department of Cardiovascular Surgery, Fukushima Medical University＊, Fukushima, Japan）

Retrograde type A aortic dissection（RTAD）following thoracic endovascular aortic repair（TEVAR）is a lethal complication. A 54-year-old woman with bovine aortic arch presented with dilatation of the descending aorta due to chronic type B aortic dissection. She underwent TEVAR in zone 2 for closure of the entry site just below the origin of the left subclavian artery. On the day after TEAVR, she showed right hemiparesis, and was diagnosed with cerebral infarction on MRI and RTAD on CT. She underwent an emergent operation. The entry was at the proximal end of the bovine trunk, where the edge of the bare stent stuck out. We performed partial arch replacement with entry resection. Her postoperative course was uneventful. She was transferred to another hospital for rehabilitation 37 days after the surgery.

 

Jpn. J. Cardiovasc. Surg. 48:341-344（2019）

Keywords：thoracic endovascular aortic repair;retrograde type A aortic dissection;bovine aortic arch;cerebral infarction