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J Thorac Cardiovasc Surg 2006;132:697-698
© 2006 The American Association for Thoracic Surgery

Brief Communication

Transfemoral stent-graft of distal aortic arch complicated with retrograde dissection

Salvador Torregrosa, MDa,*, Hortensia Montes, MDb, Manuel Pérez, PhDa, Andrés Castelló, PhDa, Daniel Mata, PhDa, Francisco Valera, MDa, Anastasio Montero, MDa

a Department of Cardiac Surgery, Hospital Universitari La Fe, Valencia, Spain
b Department of Vascular Radiology, Hospital Universitari La Fe, Valencia, Spain.

Received for publication December 13, 2005; accepted for publication February 24, 2006.

* Address for reprints: Salvador Torregrosa Puerta, MD, Department of Cardiac Surgery, Hospital Universitari La Fe, Avenida de Campanar 21, 46009-Valencia, Spain (Email: torregrosa_sal@gva.es).

The first 20% of the full text of this article appears below.


Figure 1
Drs Pérez, Torregrosa, Valera, and Montes (left to right)


We report a case of transfemoral stent-graft placement in a patient with type B chronic dissecting aneurysm of distal aortic arch, which was complicated by retrograde dissection but was resolved successfully. We discuss the possible cause of this complication.

Clinical Summary

A 57-year old man with a history of acute thoracic pain 3 years previously was seen in September 2005 with interscapular pain. Computed tomographic scanning revealed a type B aortic dissection with 7.9-cm dilatation of distal aortic arch and proximal descending aorta. Angiography demonstrated that the aneurysm involved the left subclavian artery (Figure 1, A). The patient refused conventional surgery, so we offered endovascular treatment.


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  		Figure 1. A, False-lumen aneurysm of distal aortic arch with primary entry tear involving left subclavian artery. B, Proximal end of endovascular graft is deployed near brachiocephalic artery, and false lumen is excluded.

 
To allow enough proximal landing zone for stent-graft placement, a median sternotomy was performed, and the left common carotid and subclavian arteries . . . [Full Text of this Article]






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