An elephant trunk stent graft strayed into the false lumen leading to a death during the Sun's operation: A case report

• Published in: Zhong nan da xue xue bao. Journal of Central South University. Yi xue ban Vol. 46; no. 2; p. 217
• Main Authors: Zhou, Fushuo, Chai, Hong, Liu, Ruisheng, Song, Bing
• Format: Journal Article
• Language: English
• Published: China 28.02.2021
• Subjects: Aorta, Abdominal; Aorta, Thoracic - surgery; Aortic Dissection - diagnostic imaging; Aortic Dissection - surgery; Blood Vessel Prosthesis Implantation - adverse effects; Humans; Stents - adverse effects; Treatment Outcome; aortic arch replacement; Sun’s operation; elephant trunk stent graft; aortic dissection
• ISSN: 1672-7347
• DOI: 10.11817/j.issn.1672-7347.2021.190608

Type A aortic dissection (AD) is a critical and severe disease with high mortality. The Sun's operation is a standard surgical method for this kind of disease at present. For the procedure, an elephant trunk stent is inserted into the true lumen of the descending aorta and the aortic arch is replaced. A patient was admitted to the First Hospital of Lanzhou University due to sudden chest and back pain for 6 days. Computed tomography angiography (CTA) showed type A AD. Ascending aorta replacement, Sun's operation, and ascending aorta to right femoral artery bypass grafting were performed. After surgery, the patient's condition was worsened. The digital subtraction angiography (DSA) showed the elephant trunk stent was inserted into the false lumen of AD, leading to the occlusion of the large blood vessel at the distal part of the abdominal aorta and below. Although we performed intima puncture and endovascular aortic repair, the patient was still dead.