Repair of Stent Graft-Induced Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair / 日本心臓血管外科学会雑誌

ABSTRACT

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 (40 mm-15 cm and 34 mm-20 cm) 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.