An Unusual Complication of Surgery for Type A Dissection Treated by Thoracic Endovascular Aortic Repair

Abstract

A 58-year-old man was admitted to our hospital for massive swelling in an anterior cervical location. Nine years earlier, he underwent surgical repair of a complex type A aortic dissection. This procedure was complicated by a fistula between the anastomosis of the graft and the descending aorta, resulting in massive presternal swelling. Therefore, we performed thoracic endovascular repair with successful sealing of the prosthetic leak, achieving progressive reduction in the collection of fluid. We propose thoracic endovascular aortic repair as an alternative to open surgical repair for the treatment of complicated cases.

Key Words

Emergency TEVAR - Periprosthetic leak - Presternal swelling

• References

• 1 Coady MA, Ikonomidis JS, Cheung AT, Matsumoto AH, Chaikof EL. , et al. Surgical management of descending thoracic aortic disease: open and endovascular approaches: a scientific statement from the American Heart Association. Circulation 2010; 121: 2780-2804 . 10.1161/CIR.0b013e3181e4d033
• 2 Ehrlich MP, Rousseau H, Heijmen R, Piquet P, Beregi JP, Nienaber CA. , et al. Midterm results after endovascular treatment of acute, complicated type B dissection: the Talent Thoracic Registry. J Thorac Cardiovasc Surg 2012; 145: 159-165 . 10.1016/j.jtcvs.2011.10.093
• 3 Griepp B. EM: Aneurysms of aortic arch. , in Edmonds Jr LH. . (ed.): Cardiac Surgery in the Adult. New York: McGraw-Hill; 1997. p. 1209
• 4 Akin I, Kische S, Ince H, Nienaber CA. Indication, timing and results of endovascular treatment of type B dissection. Eur J Endovasc Surg 2009; 37: 289-296 . 10.1016/j.ejvs.2008.12.004
• 5 Cao CQ, Bannon PG, Shee R, Yan TD. Thoracic endovascular aortic repair—indications and evidence. Ann Thorac Cardiovasc Surg 2011; 17: 1-6 . 10.5761/atcs.ra.10.01612