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Case Reports
. 2014 Jun;23(2):147-50.
doi: 10.1055/s-0034-1373735.

Case Report and Review of Literature: Late Retrograde Type A Aortic Dissection With Rupture after Repair of Type B Aortic Dissection with a GORE TAG Endovascular Prosthesis

Frank Manetta  1 , Bayo Ajakaiye  2 , S Jacob Scheinerman  1 , Pey-Jen Yu  1
Affiliations
Case Reports

Case Report and Review of Literature: Late Retrograde Type A Aortic Dissection With Rupture after Repair of Type B Aortic Dissection with a GORE TAG Endovascular Prosthesis

Frank Manetta et al. Int J Angiol. 2014 Jun.

Abstract

Acute aortic dissection is the most common catastrophic condition of the aorta. Treatment options include open surgery and thoracic endovascular aortic reconstruction (TEVAR). We present a late Type A dissection as a complication of the management of descending aortic dissections with TEVAR and a review of the literature. TEVAR of the thoracic aorta is a viable treatment option for the management of complicated descending thoracic aortic dissections. Careful patient selection is necessary as medical therapy successfully treats the majority of uncomplicated Type B dissections. TEVAR should be reserved for patients with complicated Type B dissections or those who fail nonoperative management. Close postoperative monitoring is necessary when TEVAR is performed and should be accompanied by lifelong surveillance. A high level of suspicion is important to identify retrograde Type A dissections in these patients given its rarity and the ambiguity of its clinical presentation.

Keywords: aortic dissection; endograft placement; endograft repair; percutaneous; risk factors; stent.

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Conflict of interest statement

Disclosures The authors have no conflicts of interest, financial, or other disclosures.

Figures

Fig. 1
Fig. 1
Type B aortic dissection.
Fig. 2
Fig. 2
Enlargement of aortic dissection to 4.1 cm.
Fig. 3
Fig. 3
Enlargement of Type B dissection to 5.4 cm.
Fig. 4
Fig. 4
Distal landing zone for thoracic endovascular aortic reconstruction. Notice resolution of distal flap.
Fig. 5
Fig. 5
Type A dissection arising proximal to thoracic endovascular aortic reconstruction graft.
Fig. 6
Fig. 6
Dissection in the ascending aorta with hemopericardium and hemomediastinum.
See this image and copyright information in PMC

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