Key result
Total arch replacement with a frozen elephant trunk in a patient with acute type A aortic dissection resulted in postoperative paraplegia, likely due to occlusion of intercostal arteries originating from the false lumen.
Why the study?
Spinal cord injury is a serious complication after total arch replacement with an open stent graft for acute aortic dissection, and intercostal artery occlusion is considered a contributing factor.
Case Report (n=1)
No
Using open stent grafting in acute type A aortic dissection when multiple intercostal arteries originate from the false lumen may increase the risk of postoperative false lumen thrombosis leading to intercostal artery occlusion and spinal cord ischemia.
Caution with frozen elephant trunk in acute type A dissection if intercostals arise from false lumen; hypothesis-generating for preoperative imaging assessment.
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Nomura et al. (2022) conducted a case report in Acute Type A Aortic Dissection (n=1). Total arch replacement with frozen elephant trunk was evaluated on Postoperative paraplegia. Total arch replacement with a frozen elephant trunk in a patient with acute type A aortic dissection resulted in postoperative paraplegia, likely due to occlusion of intercostal arteries originating from the false lumen.
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