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RETROGRADE TYPE A AORTIC DISSECTION AFTER ENDOVASCULAR THORACIC AORTIC REPAIR: RESULTS AT VIET DUC UNIVERSITY HOSPITAL
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Abstract
Background: Retrograde type A aortic dissection after thoracic aortic endovascular repair is a rare but lethal complication. We retrospectively analysis clinical cases with retrograde type A aortic dissection after thoracic aortic endovascular repair at Cardiovascular and Thoracic Center - Viet Duc Hospital and reviewed the literature. Patient and methods: This is retrospective, descriptive study of patients, who had retrograde type A aortic dissection after thoracic aortic endovascular repair from 2017 to 2021. Results: There were 7 patients in this study, the average age was 56.9±13.9 years (31-70). The male/female ratio was 5/2. Reasons for first intervention were: type B aortic dissection in fine (71.4%), of which acute dissection was in four (57.1%); aneurysm of descending aorta and aortic arch in two (28.6%). Two (28.6%) patients had ascending aorta diameter > 4cm. Marfan syndrome was presented in one (14.3%). The proximal landing zone from zone 0 to zone 2, in which the zone 0 accounts for 14.3%, the zone I and II have the same ratio and equal to 42.9%. The stent graft oversizing was from 9 to 9.7%. Four patients underwent total aortic arch and ascending aorta replacement and two patients were died on operating table before surgery, one patient died at province hospital, one patient died after surgery, the survival rate was 42.9%, postoperative mortality rate was 25%, the total mortality rate was 57.1%. Conclusion: Retrograde type A aortic dissection after endovascular intervention is a serious complication, rapid progression with high mortality even with timely surgery. Assess risk factors before intervention and select appropriate treatment options to help reduce this complication rate.
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Keywords
Retrograde type A aortic dissection, aortic endovascular repair
References
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