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Endovascular repair of complicated chronic distal aortic dissections: Intermediate outcomes and complications  Woong Chol Kang, MD, PhD, Roy K. Greenberg,

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Presentation on theme: "Endovascular repair of complicated chronic distal aortic dissections: Intermediate outcomes and complications  Woong Chol Kang, MD, PhD, Roy K. Greenberg,"— Presentation transcript:

1 Endovascular repair of complicated chronic distal aortic dissections: Intermediate outcomes and complications  Woong Chol Kang, MD, PhD, Roy K. Greenberg, MD, Tara M. Mastracci, MD, Matthew J. Eagleton, MD, Adrian V. Hernandez, MD, PhD, Akshat C. Pujara, BA, Eric E. Roselli, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 142, Issue 5, Pages (November 2011) DOI: /j.jtcvs Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Ruptured retrograde proximal dissection (arrows) identified at autopsy. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Product–limit survival estimate curves. A, Overall survival. B, Freedom from reintervention. C, Survival free from intervention. D, Complete thrombosis of false lumen in patients with limited (blue) and extensive (pink) dissections. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 A 54-year-old woman presented with a true lumen compression 4 months after the initial dissection. The preoperative CT scan showed an entry tear in the mid-descending aorta (arrow, A) with a thick intimal flap. The true lumen was extremely reduced in size (arrows, B) with subsequent renal ischemia, as confirmed by preoperative angiography. Of note, the right kidney was perfused by the false lumen (arrows, C). The true lumen enlarged significantly immediately after endograft deployment (arrows, D). At 1 year follow-up, the CT scan shows a thrombosis of the false lumen and a satisfactory expansion of the true lumen (E). The bypass to the kidney remains patent on 3D reconstructions (F). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Chronic dissection (A) is characterized by a thickened, less mobile septum and multiple mature fenestrations between the true and false lumens, making the aorta less susceptible to remodeling than is seen with acute aortic dissection (B). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

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