Amplatzer Vascular Plug for Complicated Residual DeBakey Type 1 Aortic Dissection in the Aortic Arch

Abstract

Surgical treatment of acute DeBakey type I aortic dissection does not address the entire aorta, which can leave anatomically complex residual aortic dissection in the aortic arch and descending aorta. Open repair has been the standard treatment for this pathology. When the lesions are located in the aortic arch, re-do total arch replacement needs to be performed. Plug placement to close small entry tears in the aortic arch has been reported. This article reports about a 79-year-old man who underwent hemiarch replacement for acute DeBakey type I aortic dissection. One year later, his proximal descending aorta dilated to 6.3 cm. The patient was treated with Amplatzer plug in the false lumen, and a stent graft was placed in the true lumen. Follow-up computed tomography scan confirmed complete thrombosis of the false lumen in the descending aorta which had decreased from 6.3 to 4.0 cm. Plug placement in the false lumen in the aortic arch is a potential treatment strategy for anatomically complex residual aortic dissection to induce thrombosis of the false lumen and encourage remodeling.

Keywords

plug placement residual aortic dissection

Get full access to this article

View all access options for this article.

References

et al. False lumen status in patients with acute aortic dissection: a systematic review and meta-analysis. J Am Heart Assoc 2016; 5: e003172.27166218

Preventza

Price

MD.

Simpson

et al. Hemiarch and total arch surgery in patients with previous repair of acute type I aortic dissection. Ann Thorac Surg 2015; 100: 833–838.26116478

Bajona

Quintana

Schaff

et al. Aortic arch surgery after previous type A dissection repair: results up to 5 years. Interact Cardiovasc Thorac Surg 2015; 21: 81–86.25842076

Kim

T-H.

Lee

JH.

Shim

W-H

. Embolization of persistent false lumen through reentry tear in a patient who underwent hemiarch replacement operation due to type A dissection. Ann Thorac Surg 2015; 99: e43–e45.25639444

Falkenberg

Roos

Lepore

et al. Endovascular closure of chronic dissection entries in the aortic arch using the Amplatzer Vascular Plug II as a sealing button. J Endovasc Ther 2016; 23: 378–383.26874177

Kanaoka

Ohki

Ozawa

. Repair of chronic aneurysmal aortic dissection using a stent graft and an Amplatzer^® vascular plug: a case study. Ann Vasc Surg 2017; 39: 288.e5–288.e12.27671450

Zink

JN.

Maness

MR.

Powell

et al. Coil embolization of persistent false lumen after type A dissection repair. Ann Thorac Surg 2014; 97: 2193–2196.24882307

Hata

Iida

Asai

et al. Endovascular entry closure using Amplatzer vascular plug for the aortic dissection in sub-acute phase. J Cardiol Cases 2018; 17: 111–115.30279869

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

1.45 MB