Stent Graft Implantation into a False Lumen of a Chronic Type B Aortic Dissection after Surgical Abdominal Aortic Fenestration

Chihiro Ito＊	Hideki Ueda＊	Hiroki Kohno＊
Kaoru Matsuura＊	Yusaku Tamura＊	Michiko Watanabe＊
Goro Matsumiya＊

（Department of Cardiovascular Surgery, Chiba University Hospital＊, Chiba, Japan）

A 57-year-old man, who had suffered chest, back and right leg pain about 10 years before, underwent CT and was found a chronic type B aortic dissection with an enlarged false lumen and a narrowed true lumen that was occluded at the infrarenal abdominal aorta. A conventional surgical repair seemed to be too high risk considering his comorbidities, thus we chose a staged hybrid repair. First, surgical repair of the abdominal aorta with an abdominal aortic fenestration was performed. Then, one month after the first operation, zone 2 thoracic endovascular aortic repair with left carotid-axillary artery bypass was performed. At the second operation, the stent graft was purposely deployed from zone 2 into Th12 level of a false lumen through the fenestration followed by coil embolization of a true lumen just distal to the entry tear. The postoperative course was uneventful and he had no complications at 6 months follow-up. Deploying stent graft into a false lumen could be a feasible option in case deploying into a true lumen is not suitable if the anatomical condition permits.

 

Jpn. J. Cardiovasc. Surg. 49:380-384（2020）

Keywords：chronic type B aortic dissection;TEVAR;deployment into false lumen;aortic fenestration