Stent Graft Migration Causing Two Aortic Wall Injuries 10 Years After Type II Hybrid Arch Repair

Hybrid arch repair (HAR) combines surgical reconstruction of the ascending aorta and arch debranching with stent graft deployment into the descending thoracic aorta in an effort to reduce the morbidity associated with conventional open total arch replacement. We describe a case of delayed presentation for 2 thoracic aortic wall injuries caused by stent graft migration after type II HAR. This report highlights an important late complication of HAR and the need for careful device selection. It also underlines the importance of lifelong imaging surveillance for patients undergoing complex aortic arch reconstruction.