Fracture of bare Spring Stent Deployed on Aortic Arch after TEVAR

Shin-Ah Son, Young Eun Kim, Jong Tae Lee, Gun Jik Kim

Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Republic of Korea

Purpose : A 68-year old male patient was admitted complaining of sudden onset right arm weakness and severe pain. The patient received thoracic endovascular aortic repair (TEVAR) two years ago due to Stanford type B aortic dissection and was being followed on a regular basis via outpatient clinic visits. Initial chest Computed Tomography (CT) findings showed Stanford type A aortic dissection with true lumen collapse of innominate artery. The patient’s right arm pain subsided within hours and was scheduled for elective operation after two days.

Methods : Perioperative findings showed fracture of the previously deployed bare spring stent and resulting retrograde type A aortic dissection. The patient received partial arch replacement under cardiopulmonary bypass.

Results : He suffered from acute renal failure due to rhabdomyolysis following surgery, but fully recovered. He discharged on POD 37 without complications.

Conclusion : Retrograde type A aortic dissection following TEVAR is low in incidence but has high mortality rates. Stent graft on aortic arch with acute curve can result bird-beak position, it can be lead to fracture of bare spring stent under turbulent aortic flow. Therefore, careful consideration of patient selection and stent graft deployment on aortic arch must be employed.

책임저자: Gun Jik Kim

Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Republic of Korea

발표자: Shin-Ah Son, E-mail : sina2-2@hanmail.net