Abstract
Abstract
Background
Total arch replacement using elephant trunk (ET) has been accepted as a standard technique for thoracic aortic dissection. However, there are few complications related to the ET, such as kinking of the ET, paraplegia, splitting of the anastomosis, and thromboembolic complications. We report a successful thoracic endovascular aortic repair (TEVAR) in a patient with ET entrapment in a new isolated dissecting aortic aneurysm.
Case presentation
A 50-year-old woman who underwent total arch replacement (TAR) with the ET technique 6 years ago was admitted with refractory hypertension and heart failure. Magnetic resonance angiography revealed that the ET was entrapped in an isolated dissecting aortic aneurysm, which obstructed blood flow, thus causing ischemia. She underwent TEVAR to reset the entrapment of the ET. After TEVAR, ischemic symptoms were immediately relieved.
Conclusion
We present a case of new entry after the repair of a type A acute aortic dissection using ET, which rapidly progressed to a distal arch dissecting aneurysm and dislocation of the ET.
Publisher
Springer Science and Business Media LLC
Reference7 articles.
1. Borst HG, Walterbusch G, Schaps D. Extensive aortic replacement using “elephant trunk” prosthesis. Throrac Cardiovasc Surg. 1983;31:37–40.
2. Heuts S, Adriaans BP, et al. Extending arch in acute type A aortic dissection: a meta-analysis of short term outcomes and long term actuarial survival. Eur J Vasc Endovasc Surg. 2022;63(5):674–87.
3. Smith HN, Boodhwani M, Ouzounian M, et al. Classification and outcomes of extended arch repair for acute type a aortic dissection: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2017;24(3):450–9.
4. Ergin MA, Phillips RA, Galla JD, et al. Significance of distal false lumen after type A dissection repair. Ann Thorac Surg. 1994;57:820–5.
5. Takahara Y, Sudo Y, Mogi K, et al. Total aortic archgrafting for acute type A dissection: analysis of residual false lumen. Ann Thorac Surg. 2002;73:450–4.