Descending aortic banding for re-rupture of retrograde aortic dissection after emergency thoracic endovascular aortic repair

Conversion to open repair after thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection is rare, but inevitable. We present a case of an 86-year-old man with ruptured type B aortic dissection after TEVAR. He received a successful stent-graft implantation of the descending aort...

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Published inGeneral thoracic and cardiovascular surgery Vol. 68; no. 1; pp. 70 - 73
Main Authors Hattori, Shigeru, Noguchi, Kenichiro, Gunji, Yusuke, Nagatsuka, Motoki, Yamabe, Tsuyoshi, Ogino, Hidemitsu, Katayama, Ikuo
Format Journal Article
LanguageEnglish
Published Singapore Springer Singapore 2020
Springer Nature B.V
Subjects
Aged, 80 and over
Aneurysm, Dissecting - surgery
Aortic Aneurysm, Thoracic - surgery
Aortic aneurysms
Aortic dissection
Blood Vessel Prosthesis Implantation - methods
Cardiac Surgery
Cardiology
Case Report
Coronary vessels
Endovascular Procedures - methods
Humans
Intervention
Male
Medicine
Medicine & Public Health
Mortality
Ostomy
Paralysis
Recurrence
Stents
Surgery
Surgical Oncology
Thoracic Surgery
Thoracotomy - methods
Thrombosis - surgery
Time Factors
Treatment Outcome
Veins & arteries
United States > US
Japan
Open conversion
Aortic dissection
Aortic banding
False lumen rupture
TEVAR
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Summary:Conversion to open repair after thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection is rare, but inevitable. We present a case of an 86-year-old man with ruptured type B aortic dissection after TEVAR. He received a successful stent-graft implantation of the descending aorta without any type of endoleak. After the patient was transferred to the intensive care unit, he went into a shock state. Contrast-enhanced CT revealed a re-rupture of acute retrograde type B aortic dissection. The false lumen was patent and perforated to the left thorax. Left thoracotomy and descending aortic banding was performed. Descending aorta was encircled with a woven Dacron graft at the distal part of the rupture site to compress the patent false lumen. The bleeding was stopped, and the follow-up CT showed false lumen thrombosis. Descending aortic banding is one of the quick and effective open conversion techniques.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-018-1016-9