Conservative management of delayed retrograde type A aortic dissection after successful hybrid endovascular repair of distal arch aneurysm.
Retrograde Type A aortic dissection following successful endovascular treatment of thoracic aortic disease is not uncommon. We report a case where the primary pathology was distal aortic arch aneurysm without dissection, and the retrograde type A dissection occurred four months after successful hybrid endovascular management with right to left carotid bypass and stent-graft with a Cook Zenith device. As the patient was not medically fit for sternotomy and repair of Type A aortic dissection, progress was monitored with serial CT scans. This case demonstrates that delayed retrograde type A dissection can occur even in cases when there was no previous aortic dissection, and that in selective patients who are poor candidates for major aortic surgery, a conservative approach can be adopted.
Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14th Floor K Block, Queen Mary Hospital, Hong Kong.
W H
WH
She
Y C
YC
Chan
A C
AC
Ting
S W
SW
Cheng
D000368:Aged; D000784:Aortic Dissection / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery / Q000628:therapy*; D002339:Carotid Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D015607:Stents