Retrograde type A aortic dissection (RAAD) may occur early or late following thoracic endovascular aortic/aneurysm repair procedures. We present images of a RAAD following an open repair of a thoraco‐abdominal aortic aneurysm (TAAA).A 59‐year‐old male underwent a repair of a 6‐cm extent II TAAA which had progressively increased over 1 year following an acute type B aortic dissection (Figure ).Preoperative computed tomography scan (3‐dimensional reconstruction) shows the extent II thoraco‐abdominal aortic aneurysm with chronic type B aortic dissection flap (yellow arrow)At the time of surgery, a left thoraco‐abdominal incision was performed and the chest entered through the 6th interspace. Partial cardiopulmonary bypass (CPB) was instituted with left femoral artery and venous cannulation. The aorta was clamped between the left carotid and subclavian arteries, and a #26‐mm Gelweave thoraco‐abdominal graft (Vascutek Ltd, Inchinnan, Scotland) was placed distal to the left subclavian artery extending to the infra‐renal abdominal aorta. T9 and 10 segmental intercostal arteries as well as the visceral and renal arteries were re‐attached to the graft. The patient tolerated the procedure well; however, on the evening of surgery, he developed cardiac tamponade, which required emergent pericardial drainage at the bedside. A computed tomography (CT) angiogram examination revealed a RAAD
Journal of Cardiac Surgery – Wiley
Published: Jan 1, 2018
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