scholarly journals A Case of Acute Type B Aortic Dissection Subsequent to Asymptomatic Chronic Type A Aortic Dissection Which Was Difficult to Distinguish from Acute Type A Aortic Dissection

2020 ◽  
Vol 49 (2) ◽  
pp. 77-80
Author(s):  
Hitoshi Suzuki ◽  
Yasuhiro Sawada ◽  
Kentaro Inoue ◽  
Masaki Yada ◽  
Uhito Yuasa ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Type A Aortic Dissection

scholarly journals Anatomy of the retrograde type A aortic dissection after endovascular repair of type B aortic dissection: a case report

2021 ◽  
Vol 0 (Ahead of Print) ◽  
Author(s):  
Uliana Pidvalna ◽  
Marianna Mirchuk ◽  
Anna Voitovych ◽  
Dmytro Beshley
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Type A ◽  
Ascending Aorta ◽  
Medical Attention ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Type A Aortic Dissection ◽  
Aortic Replacement

Aortic dissection requires immediate medical attention. The optimal treatment approach of Type B aortic dissection is still a matter of debate. Possible options include open surgery, endovascular aortic repair (EVAR), and hybrid procedure. The indication for surgery is the dissection that involves the ascending aorta and the aortic arch (Type A Stanford, Types I and II DeBakey). Hybrid or endovascular procedures seem to be an attractive alternative treatment for patients with the complex aortic disease and a high risk of surgery. Endovascular treatment of acute Type B aortic dissections is designed to prevent the retrograde dissection of the ascending aorta and the aortic arch. The occurrence of retrograde Type A aortic dissection (RTAD) is rare, but the mortality rate is high. We report a case of a 55-year-old gentleman who had undergone thoracic EVAR. Thirty months after the given procedure he presented with RTAD and underwent supracoronary aortic replacement. The article is intended to remind the clinicians of the importance of early detection of the possible complications when performing EVAR, and the significance of a rapid response.

Extended thoracic endovascular aortic repair for residual aortic dissection after type A aortic dissection repair

Vascular ◽  
2021 ◽  
pp. 170853812098841
Author(s):  
Yasunori Iida ◽  
Takashi Hachiya ◽  
Ryota Asano ◽  
Shinya Inoue ◽  
Susumu Fujii ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Thoracic Aorta ◽  
Type A ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Descending Thoracic Aorta ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Type A Aortic Dissection

Objective We investigated the outcomes of extended coverage of the descending thoracic aorta by thoracic endovascular aortic repair (TEVAR) for residual chronic type B aortic dissection after type A aortic dissection (TAAD) repair. Methods From November 2015 to August 2020, 36 patients underwent extended TEVAR for residual intimal tear after TAAD repair. We specifically investigated the methods and outcomes of this procedure. Results TEVAR consisted of isolated TEVARs ( n = 29), single-vessel debranching TEVAR (6), and two-vessel debranching TEVAR (1). The mean time from TAAD repair to TEVAR was 27 ± 33 months (2–86 months). The TEVAR devices used were Valiant (28 cases), GORETAG (4), Relay plus (2), and TX2 (2). Technical success of TEVAR was 100%. The distal ends of the stent grafts were T 8 (1 case), T 9 (5), T 10 (6), T 11 (9), and T 12 (15), with an average of T 11 ± 1. The average length of hospital stay after TEVAR was 9 ± 3 days (5–17 days). There were no surgical/hospital deaths or complications. The average postoperative follow-up period was 21 ± 15 months without death or reintervention. Conclusions The short-term outcomes of extended TEVAR for residual chronic type B aortic dissection after TAAD repair were acceptable without perioperative SCI. Aggressive descending thoracic aorta coverage may prevent aortic events, and extended TEVAR may be a preemptive treatment for the downstream aorta. Mid- to long-term results should be clarified.

Type A Intramural Hematoma in the Setting of Acute Type B Aortic Dissection

2013 ◽  
Vol 96 (5) ◽  
pp. 1868-1870
Author(s):  
Christina M. Vassileva ◽  
Blaine T. Manning ◽  
Theresa M. Boley ◽  
Stephen R. Hazelrigg
Keyword(s):  
Aortic Dissection ◽  
Intramural Hematoma ◽  
Type A ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection

Hybrid Thoracic Stent Graft Repair of a Complex Type B Aortic Dissection in a Patient who Presented Three Weeks after Repair of a Type a Aortic Dissection

2008 ◽  
Vol 3 (3) ◽  
pp. 158-160
Author(s):  
Puja Gaur ◽  
Karthikeshwar Kasirajan ◽  
Daniel L. Miller ◽  
Thomas A. Vassiliades
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Hybrid Approach ◽  
False Lumen ◽  
Type A ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Type A Aortic Dissection ◽  
Stent Graft Repair ◽  
Thoracic Stent Graft

Long-term management after repair of a type A aortic dissection includes aggressive medical therapy and routine surveillance with serial imaging to ensure thrombosis of the false lumen. Retained patency of the false lumen can lead to either the development of a false lumen aneurysm with a subsequent rupture or extension of dissection. Typically such events occur late, usually months after repair, and are treated with either a conventional one-stage open thoracoabdominal repair or a two-stage “elephant trunk” procedure. However, most patients who undergo such procedures experience major complications and the procedure-related mortality rate is high. We present a unique case of a 61-year-old woman who presented with a ruptured type B aortic dissection 3 weeks after repair of a type A aortic dissection. She underwent an emergent thoracotomy and primary repair of the ruptured aorta followed by concomitant arch debranching and thoracic stent graft placement. Simultaneous surgical debranching with a median sternotomy and endovascular repair with stent grafts is an attractive hybrid approach in patients who present with an acute rupture of a false lumen aneurysm soon after initial repair of an aortic dissection, a situation in which a conventional repair is not feasible. This report emphasizes that hybrid thoracic stent graft repair should be considered for such high-risk patients in the near future as it offers them relatively lower morbidity and mortality compared with what is seen with conventional repairs.

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