[Surgical treatment patients with retrogarde type A aortic dissection after thoracic endovascular repare]

Retrograde aortic dissection of type A is the most dangerous and difficult-to-predict complication of thoracic aortic arthroplasty. In this complication, without timely surgical treatment, mortality in the first 48 hours may exceed 40%. The aim is to present the results of surgical treatment of patients with type A retrograde aortic dissection after thoracic aortic stenting.

From 2014 to 2024, 7 patients underwent open aortic arch replacement for type A retrograde aortic dissection after thoracic aortic arthroplasty. 3 patients underwent surgery in the early period, and 4 in the long-term period after stenting.

There was no hospital mortality. In the early and late postoperative periods, neurological complications, the development of multiple organ failure, and malperfusion of internal organs were not noted. In the long-term follow-up period, 4 years after surgery, 1 patient died (aorto-unassociated mortality).

Emergency open surgery is the method of choice for type A retrograde aortic dissection after aortic arthroplasty. This approach leads to good early and long-term results. All patients with distal aortic dissection require lifelong monitoring for timely diagnosis of possible complications.