title: Delayed retrograde aortic dissection after endovascular stenting of the descending thoracic aorta.
abstract: A 66-year-old patient underwent emergency endovascular repair of a descending thoracic aneurysm because of suspected aortic rupture. Two weeks later, a small saccular aneurysm of the aortic arch was treated with open surgery. An unexpected intraoperative finding was retrograde dissection of the aortic arch and of the ascending aorta that was not seen on the postprocedural computed tomographic scans after endografting. The ascending aorta, the aortic arch, and the proximal part of the descending thoracic aorta were successfully replaced with a Dacron graft with deep hypothermia, circulatory arrest, and retrograde cerebral perfusion. Awareness that this life-threatening complication that necessitates extensive cardiovascular surgery can occur not only during or immediately after endovascular stenting of the thoracic aorta but also as much as several days or perhaps even weeks after the procedure is important.
authors.affiliation: Deutsches Herzzentrum Berlin, Germany. pasic@dhzb.de
authors.forename: Miralem
authors.initials: M
authors.lastname: Pasic
authors.forename: Peter
authors.initials: P
authors.lastname: Bergs
authors.forename: Friedrich
authors.initials: F
authors.lastname: Knollmann
authors.forename: Burkhart
authors.initials: B
authors.lastname: Zipfel
authors.forename: Peter
authors.initials: P
authors.lastname: Müller
authors.forename: Michael
authors.initials: M
authors.lastname: Hofmann
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004452:Echocardiography; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure