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Hybrid antegrade repair of the arch and descending thoracic aorta with a new integrated stent-Dacron graft in acute type A aortic dissection: a look into the future with new devices

Department of Cardiovascular Surgery, Hospital Clínico, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain

*Corresponding author. Tel.: +34-93-2275749; fax: +34-93-4514898.

E-mail address: cmestres{at}clinic.ub.es (C.-A. Mestres).

A young male patient underwent supracoronary replacement of the ascending aorta for acute type A dissection under hypothermic circulatory arrest. After discharge, he was readmitted two weeks later due to severe aortic regurgitation and acute arch redissection. Under a second period of hypothermic circulatory arrest three weeks after the initial operation, radical treatment with aortic valve replacement, replacement of the ascending aorta and arch, together with antegrade deployment of a stent-graft in the true lumen for frozen elephant-trunk technique, were successfully performed. Computed tomography at four weeks showed complete proximal repair and thrombosis of the false lumen. Transesophageal echocardiography at eight weeks confirmed repair. The patient is currently leading an active life. A hybrid approach for complex cases of acute type A dissection with arch involvement can be considered for the future.

Key Words: Acute type A aortic dissection; False lumen; Stent-graft; Antegrade deployment

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