A Case of Thoracic Endovascular Aortic Repair with Fenestrated Stentgraft for Ulcer-like Projection of the Proximal Anastomosis after Total Arch Replacement for Acute Type A Aortic Dissection after Open Heart Surgery

(Department of Cardiovascular Surgery, and Department of Radiology*, Kagawa Prefectural Central Hospital, Takamatsu, Japan)

Shu Yamamoto Atsushi Aoki Takanori Suezawa
Mitsuhisa Kotani Mamoru Tago Jun Sakurai*
We report a case of thoracic endovascular aortic repair(TEVAR)with a fenestrated stent graft for ulcer-like projection(ULP)of the proximal anastomosis after total arch replacement(TAR)for acute type A aortic dissection(DAA). A 73-year-old woman with a history of surgical resection of a left atrial myxoma in January 2009 underwent TAR for DAA in November 2011. The contrast enhanced CT(CE-CT)72 days after TAR revealed two ULPs anterior and posterior to the proximal anastomosis. Surgical repair would be difficult because of the history of cardiac and aortic surgery, therefore TEVAR with a fenestrated stent graft was performed. The postoperative course was uneventful and she was discharged on the 8th postoperative day. The CE-CT 3 months after TEVAR showed almost completely thrombosed ULPs. Endovascular repair with fenestrated stent graft for the proximal anastomotic ULP can be a useful and effective treatment.
  Jpn. J. Cardiovasc. Surg. 42:132-136(2013)

Keywords:type A aortic dissection, ulcer-like projection, thoracic endovascular aortic repair, fenestrated stent graft