A New and Unexpected Complication After Arch Stent Grafting for Residual Dissection

This report describes a complication after stent grafting of the aortic arch for residual dissection after ascending aorta and aortic arch replacement for acute type A dissection. One year later, a pseudoaneurysm originating from the proximal suture line and therefore far from the stent graft landing zone developed and fistulized into the pulmonary artery. Possible causes were suture damage during stent deployment and change of system forces after stent placement leading to high tension on the suture line. Emergency surgery was performed. Aortic arch stent grafting is a new and promising technique, but its complications are still not completely known.