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4 . 2025

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

Abstract

Background. 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.

Material and methods. 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.

Results. 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).

Conclusion. 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.

Keywords: retrograde aortic dissection; aortic endoprosthetics; thoracic aorta; TEVAR; emergency open surgery

Conflict of interest. The authors declare no conflict of interest.

Funding. The study received no financial support.

Authors’ contribution. Study conception and design, data collection and handling, processing of the material, draft manuscript preparation, manuscript revision – Charchyan E.R., Stepanenko A.B., Chacal D.A., Breshenkov D.G., Gens A.P.

For citation: Charchyan E.R., Stepanenko A.B., Chacal D.A., Breshenkov D.G., Gens A.P. Surgical treatment patients with retrogarde type A aortic dissection after thoracic endovascular repare. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (4): 83–8. DOI: https://doi.org/10.33029/1027-6661-2025-31-4-83-88

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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