One-Stage, Hybrid Aortic Repair for a Migrated, Thrombosed, Floating Aortic Stent Graft

A 50-year-old man with an acute type B aortic dissection underwent thoracic endovascular aortic repair in 2019. The patient presented again with chest pain and left arm numbness. Computed tomography scan revealed aneurysm expansion and extensive thrombus within a floating stent graft. He underwent explantation of the stent graft, zone 2 total aortic arch replacement with frozen elephant trunk, and left axillary artery bypass. Simultaneously, he underwent retrograde thoracic endovascular aortic repair extension and controlled balloon septal rupture. Two years after surgery, he remains without complication.