Early and mid-term outcome of endovascular repair in retrograde type A aortic dissection with an entry tear located in descending aorta

摘要

Objective Acute Stanford type A aortic dissection is typically presented as antegrade dissection from a primary intimal tear in the proximal ascending aorta extending to the arch and the downstream distal aorta.However,it may also develop in a retrograde fashion with an intimal tear located in descending aorta causing retrograde extension of aortic dissection into ascending aorta,namely,retrograde type A aortic dissection(RTAAD).Though open surgery remains the golden standard to treat type A dissection,as to RTAAD,the distal location of its primary entry tear in descending aorta warrants more extensive aortic repair with higher surgical risks of mortality or morbidity through a median sternotomy.Conversely,confining the surgical extent to the proximal aorta leaves the risks of complications related to the residual tear in the distal aorta untreated.More recently,thoracic endovascular aortic repair(TEVAR)is attempted for the treatment of RTAAD with favorable shortterm and long-term prognosis.To the best of our knowledge,this was the largest serial study to apply TEVAR in the treatment of RTAAD.