Typical Retrograde Type A Dissection After Previous Type B Dissection

Stanford type B aortic dissection (TBAD) retrograde tears to Stanford type A AD (RTAAD) have been reported only rarely, but are often fatal. Early diagnosis and timely surgery are essential. We present a typical case of RTAAD after the tip of the stent directly damaged the ascending aorta wall.

A 71-year-old woman was admitted to our department for chest pain and back pain for 10 hours. She had undergone coated stent graft implantation surgery a month previously for TBAD. On first impression, we suspected the AD may have progressed or torn retrogradely. RTAAD was confirmed by computed tomography angiography, and we successfully performed open surgery.

RTAAD should be suspected in patients with chest and back pain after endovascular stent repair. Prompt recognition is essential, and early surgical treatment is strongly recommended.