[Aortic Arch Replacement Using Fenestrated Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection with Isolated Left Vertebral Artery].

Abstract

We report a case of acute type A aortic dissection (ATAAD) with an isolated left vertebral artery (ILVA), and our successful surgical treatment with a fenestrated frozen elephant trunk (FET). A 56-year-old man was referred to our department for chest and back pain. Contrast enhanced computed tomography (CT) revealed ATAAD. The left vertebral artery branched directly from the aorta. We performed total arch replacement with fenestrated FET to preserve the ILVA and left subclavian artery( LSCA) blood flow. During surgery, the aorta was transected at zone 2, and FET was deployed into the distal aorta, then we manually created a hole on the ILVA and LSCA side in the stented portion. After surgery, angiography confirmed antegrade flow in the ILVA and LSCA. Although care must be taken with the location of the intimal tear, we advocate this technique for treating ATAAD with ILVA in suitable cases.