G. Chad Hughes, MD, Asvin M. Ganapathi, MD, Jeffrey E

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Thoracic Endovascular Aortic Repair for Chronic DeBakey IIIb Aortic Dissection G. Chad Hughes, MD, Asvin M. Ganapathi, MD, Jeffrey E. Keenan, MD, Brian R. Englum, MD, Jennifer M. Hanna, MD, MBA, Matthew A. Schechter, MD, Hanghang Wang, MD, Richard L. McCann, MD The Annals of Thoracic Surgery Volume 98, Issue 6, Pages 2092-2098 (December 2014) DOI: 10.1016/j.athoracsur.2014.06.066 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Computed tomography angiography images from a patient early in the series who underwent thoracic endovascular aortic repair for a proximal descending aneurysm developing adjacent to the primary tear. The preoperative image (left) demonstrates a small diameter true lumen (TL) in the planned distal landing zone in the mid-descending thoracic aorta, and the postoperative image (right) shows a stent graft-induced new entry tear (SINE) at this level caused by tearing of the dissection membrane by the distal end of the device, which was excessively oversized relative to the true lumen diameter. (B) Three-dimensional reconstruction computed tomography angiography image demonstrating significant perfusion of the false lumen via the stent graft-induced new entry tear 1 month after thoracic endovascular aortic repair. (C) Reintervention with a distal extension prosthesis to exclude the stent graft-induced new entry tear was performed, and three-dimensional reconstruction computed tomography angiography 6 years after reintervention demonstrates clinical success with near complete resolution of the thoracic false lumen with persistent abdominal dissection but normal distal aortic diameters. The Annals of Thoracic Surgery 2014 98, 2092-2098DOI: (10.1016/j.athoracsur.2014.06.066) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Actuarial (Kaplan-Meier) overall (solid line) and aorta-specific (dashed line) survival. The Annals of Thoracic Surgery 2014 98, 2092-2098DOI: (10.1016/j.athoracsur.2014.06.066) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions