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Case Reports
. 2017 Jan;6(1):e25-e28.
doi: 10.1055/s-0037-1606285. Epub 2017 Aug 25.

Old Solutions for New Troubles in Complications after Thoracic Endovascular Aortic Repair

German Alberto Fortunato  1 , Guillermo Stöger  1 , Ricardo Gustavo Marenchino  1 , Vadim Kotowicz  1
Affiliations
Case Reports

Old Solutions for New Troubles in Complications after Thoracic Endovascular Aortic Repair

German Alberto Fortunato et al. Thorac Cardiovasc Surg Rep. 2017 Jan.

Abstract

Background The authors present two cases with type B aortic dissection initially treated by endovascular stent graft who developed aortic complications posttreatment and required surgical treatment. Case Description A 50-year-old woman and a 65-year-old man underwent endovascular treatment for thoracic aortic aneurysm associated with type B dissection and -both of them evolved with endoleak type 1. The first case was related to aortobronchial fistula, and the second one was associated with ascending aortic aneurysm. An extra-anatomical ascending aorta-supraceliac aorta bypass grafting was decided due to the persistent leak. Conclusion Surgery is an excellent choice for complex complications after thoracic endovascular aortic repair with previous failed attempts of endovascular resolution.

Keywords: aortic bypass graft; complications; extra-anatomical aorto-aortic bypass; thoracic endovascular aortic repair.

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Conflict of interest statement

Conflict of Interest The authors have no conflicts of interest relevant to this publication.

Figures

Fig. 1
Fig. 1
Case 1: Preoperative CT scan showing proximal endoleak (yellow arrow) and contact of the aneurysmal sac with airway. Case 2 : Aneurysm of ascending aorta and proximal endoleak (yellow arrow).
Fig. 2
Fig. 2
( A ) Extra anatomical aorto-aortic bypass from ascending aorta (Ao) to supraceliac aorta with dacron graft (pr) through the diaphragm (d). ( B ) Stent removed. ( C ) Thoracic aortic resection and removal of clots.
Fig. 3
Fig. 3
Case 1: Postoperative 3D recostruction. Extra anatomical aorto-aortic bypass with dacron graft (yellow arrow). Case 2: Postoperative 3D recostruction showing ( a ) aorto-aortic bypass, ( b ) brachiocephalic artery, ( c ) left subclavian bypass, ( d ) left carotid artery.
See this image and copyright information in PMC

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