Utility of dual longitudinal diameter-reducing ties in aortic arch thoracic endovascular aortic repair

摘要

A 69-year-old man underwent open surgical ascending aortic replacement for type-A aortic dissection. Six months after this operation, he became symptomatic. There was persistent chest pain even though anti-hypertensive treatment was effective. Computed tomography angiography showed a widening false lumen (FL) in the aortic arch and in the thoracic aorta ( ). The patient was not suitable for open aortic arch replacement due to high risk (logistic EuroSCORE 34.47%). Standard thoracic endovascular aortic repair (TEVAR) or branched endovascular repair (e.g. COOK) [ ] was not considered due to insufficient landing zone distal to a right coronary artery venous bypass graft arising from the ascending aortic graft.