Deployment of endograft in the ascending aorta to reverse type A aortic dissection.
Current surgery to treat acute type A aortic dissection involving an intimal tear in the ascending aorta consists of resection and replacement, but mortality is high. We report the case of a 46-year-old female patient with Marfan syndrome who presented with excruciating retrosternal pain and breathing distress after a bowel movement with stress. Magnetic resonance imaging and multicolour sonography showed type A aortic dissection extending from the aortic root to the right iliac artery, with intimal tears in the ascending aorta above the sinotubular junction, the distal arch beyond the left subclavian artery and the isthmic region. We adapted the endoluminal stenting technique to this case of type A aortic dissection by sealing the intimal tears in the ascending aorta using endovascular introduction of one endoluminal graft, as confirmed on angiography. The patient was discharged after 10 days. Follow-up examination by computed tomography after more than 1 year revealed no sign of dissection at any level of the aorta.
Wang
Zhong Gao
ZG
Vascular Institute, First Affiliate Hospital, College of Medicine, Zhejiang University, Hangzhou, China. zhonggaowang@yahoo.com
Massimo
Carlo G
CG
Li
Ming
M
Pan
Song Ling
SL
Zhang
Hong Kun
HK
Jing
Wei
W
Zhao
Hai Ge
HG
Chen
Xu Dong
XD
Chen
Hong
H
D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008875:Middle Aged