Endovascular fenestration in aortic type-A dissection with hepatic malperfusion syndrome: a case report

Abstract Background: Fenestration of the dissection membrane in aortic dissection is a viable treatment option for abdominal malperfusion syndrome. While open surgical approaches are commonly chosen for type-A (DeBakey I and II) dissections, endovascular treatment gains importance in type-B dissections, particularly for patients unsuitable for surgery or in a combined approach. Case presentation: We present a case of an acute type-A (DeBakey I) aortic dissection in a patient who underwent a David-Procedure combined with a partial aortic arch replacement and was subsequently treated for hepatic malperfusion syndrome using an endovascular approach. Conclusions: The interdisciplinary approach led to a favorable clinical outcome, suggesting that endovascular treatment should be considered for patients with type-A dissection and abdominal malperfusion syndrome.