[Thoracic Endovascular Aortic Repair for Re-entry of Distal Anastomosis Following Ascending Replacement for Acute Aortic Dissection:Report of a Case].

Abstract

A 61-year-old female underwent ascending aortic replacement (resecting the primary entry in the ascending aorta) for Stanford type A acute aortic dissection 1 year and 8 months before. Her postoperative course was uneventful, and the patient was discharged on 17 days later. Follow-up recent computed tomography (CT) scans, however, revealed dissecting aortic aneurysm of the distal aortic arch due to a new entry at the distal anastomosis of the ascending replacement. Thoracic endovascular aor-tic repair( placing a short stent graft, 52-mm Valiant Navion, into the ascending aorta) was successfully performed to occlude the new entry. Post-procedural CT scans indicated retrograde flow into the false lumen of the aortic arch via a re-entry of the left subclavian artery, and endovascular repair to exclude the re-entry is now planned.