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Acute iatrogenic type A aortic dissection following thoracic aortic endografting.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2010 Apr; Vol. 51 (4), pp. 993-9. - Publication Year :
- 2010
-
Abstract
- Endovascular intervention has emerged as a less traumatic alternative treatment for several diseases of the thoracic aorta.(1,2) However, depending on the different aortic pathologies, procedure related complications have become increasingly evident: severe complications include type I endoleaks, migration, and endograft (EG) collapse, as well as those observed during conventional surgery (eg, stroke and paraplegia).(3,4) One of the emerging and most alarming complication of thoracic endografting is iatrogenic retrograde type A acute dissection (RTAAD).(5) Retrograde type A acute dissection is defined as acute aortic dissection that originates distally to the ascending aorta with a retrograde flap progression into the ascending aorta.(6) This complication has been previously described during conventional cardiac surgery with high mortality rate; previous case reports suggested that the fragility of the aortic wall and Marfan disease were predisposing factors to such a life-threatening complication.(7-9) This report presents a case of iatrogenic RTAAD after EG repair of a descending thoracic penetrating aortic ulcer, requiring emergent surgical replacement of the ascending aorta and the aortic arch. The available English literature on RTAAD was also reviewed, in order to recognize potential predisposing factors and specific strategies to prevent it.
- Subjects :
- Acute Disease
Aged
Aortic Dissection diagnostic imaging
Aortic Dissection surgery
Aorta, Thoracic diagnostic imaging
Aortic Aneurysm diagnostic imaging
Aortic Aneurysm surgery
Aortic Diseases diagnostic imaging
Aortography methods
Fatal Outcome
Humans
Male
Reoperation
Tomography, X-Ray Computed
Treatment Outcome
Ulcer diagnostic imaging
Aortic Dissection etiology
Aorta, Thoracic surgery
Aortic Aneurysm etiology
Aortic Diseases surgery
Blood Vessel Prosthesis Implantation adverse effects
Iatrogenic Disease
Ulcer surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 51
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 20347697
- Full Text :
- https://doi.org/10.1016/j.jvs.2009.10.105