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One-Stage, Hybrid Aortic Repair for a Migrated, Thrombosed, Floating Aortic Stent Graft
A Claire Watkins1, Mavi Eyuboglu2, Aleena Yasin1
1Department of Cardiothoracic Surgery, Stanford School of Medicine, Stanford, California.
Annals of Thoracic Surgery Short Reports
|January 10, 2025
Summary
A complex aortic dissection case required advanced surgical techniques including stent graft explantation and frozen elephant trunk repair. The patient recovered well, demonstrating the efficacy of these complex aortic interventions.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- A 50-year-old male presented with acute type B aortic dissection.
- Initial treatment involved thoracic endovascular aortic repair (TEVAR) in 2019.
Observation:
- The patient developed recurrent symptoms of chest pain and left arm numbness.
- Computed tomography revealed significant aneurysm expansion and extensive thrombus within the previously placed stent graft.
Findings:
- A complex re-intervention was performed, including stent graft explantation.
- The procedure involved zone 2 total aortic arch replacement with frozen elephant trunk (FET) and left axillary artery bypass.
- Simultaneously, retrograde thoracic endovascular aortic repair (TEVAR) extension and controlled balloon septal rupture were utilized.
Implications:
- This case highlights the successful management of a complex endograft complication after TEVAR.
- The combination of open and endovascular techniques (hybrid approach) proved effective for aortic arch pathology.
- The patient remained free of complications two years post-operatively, suggesting long-term durability.
