Conservative Management of Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair

Abstract

Retrograde type A aortic dissection following endovascular treatment for thoracic aortic disease is not uncommon. We report the case of an 81-year-old woman who was admitted to our hospital for a distal aortic arch aneurysm with a penetrating atherosclerotic ulcer. As the patient was not medically fit for sternotomy and repair of the aortic arch, she selected thoracic endovascular aortic repair (TEVAR). Just after TEVAR, a retrograde type A aortic dissection occurred. Since her vital signs, such as blood pressure, were stable, a conservative approach was adopted, and the progression of the retrograde dissection was monitored with serial computed tomography scans. This case report suggests that, for select patients who are poor candidates for major aortic surgery, a conservative approach can be effective.