title: Case report and review of the literature total endovascular repair of acute ascending aortic rupture: a case report and review of the literature.
abstract: Thoracic aortic endografting has been successfully implemented to treat aneurysmal disease of the distal aortic arch and descending thoracic aorta. Although there are reports of ascending aortic endovascular interventions, the total endovascular repair of a ruptured ascending aorta secondary to a Type A dissection has not been described. We report the case of a 77-year-old patient who presented with a ruptured ascending aortic aneurysm secondary to degeneration of a Stanford type A aortic dissection. His surgical history was significant for orthotropic heart transplant 19 years prior. The dissection, aneurysm, and rupture occurred in the native aorta distal to the ascending aortic suture line. At presentation, he was hemodynamically unstable with a right hemothorax. We placed 3 Medtronic Talent Thoracic Stent Graft devices (Medtronic Inc, Minneapolis, MN) across the suture line in the ascending aorta, excluding the rupture. The patient survived and has been followed to 25 months.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of California San Diego, San Diego, CA, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: McCallum
authors.forename: Karl K
authors.initials: KK
authors.lastname: Limmer
authors.forename: Anthony
authors.initials: A
authors.lastname: Perricone
authors.forename: Dennis
authors.initials: D
authors.lastname: Bandyk
authors.forename: Nikhil
authors.initials: N
authors.lastname: Kansal
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D006439:Hemodynamics; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D008297:Male; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: TEVAR; ascending aorta; endovascular repair; thoracic aorta rupture