Key result
Conservative management with serial CT scans was successfully adopted for a patient with delayed retrograde type A aortic dissection who was unfit for major surgery.
Case Report (n=1)
Conservative management with serial CT scans may be a viable option for high-risk surgical patients who develop delayed retrograde type A aortic dissection after endovascular repair.
May support conservative management in select inoperable patients; leaves open need for prospective validation.
Retrograde Type A aortic dissection following successful endovascular treatment of thoracic aortic disease is not uncommon. We report a case where the primary pathology was distal aortic arch aneurysm without dissection, and the retrograde type A dissection occurred four months after successful hybrid endovascular management with right to left carotid bypass and stent-graft with a Cook Zenith device. As the patient was not medically fit for sternotomy and repair of Type A aortic dissection, progress was monitored with serial CT scans. This case demonstrates that delayed retrograde type A dissection can occur even in cases when there was no previous aortic dissection, and that in selective patients who are poor candidates for major aortic surgery, a conservative approach can be adopted.
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She et al. (2010) conducted a case report in Delayed retrograde type A aortic dissection (n=1). Conservative management was evaluated. Conservative management with serial CT scans was successfully adopted for a patient with delayed retrograde type A aortic dissection who was unfit for major surgery.
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