Chronic Residual Aortic Dissection after Type A Aortic Dissection Repair: 7-year Results

BACKGROUND: Residual Type B aortic dissection (RTBAD) after Type A aortic dissection (TAAD) repair is a serious disease that requires reintervention. Thoracic endovascular aortic repair (TEVAR) for RTBAD after TAAD repair is an acceptable choice for this problem. AIM: This study aimed to investigate the outcomes of extended coverage of the descending thoracic aorta by TEVAR for RTBAD after TAAD repair. METHODS: This was a retrospective study. From November 2017 to August 2022, 12 patients were enrolled in this study. Patients underwent extended TEVAR for residual chronic Type B aortic dissection after TAAD repair. Data were collected from 12 patients in this period, and detailed patient characteristics were analyzed before, early after, and periodically after procedure. At the same time, we tried to develop an algorithm for this group of the patients. RESULTS: TEVAR consisted of isolated TEVARs (n = 12). The mean time from TAAD repair to TEVAR was 27 ± 33 months (2–86 months). Technical success of TEVAR was 100%. The distal ends of the stent grafts were T 8 (eight cases), T 9 (four cases). The average length of hospital stay after TEVAR was 3.41 day (2–5 days). There were no surgical/hospital deaths or complications. The average postoperative follow-up period was 26.75 months (22–34) without death or reintervention. CONCLUSION: The short-term outcomes of extended TEVAR for residual chronic Type B aortic dissection after TAAD repair were acceptable without major adverse aortic events. By careful systematic evaluation of the patients, coverage of the descending thoracic aorta may prevent aortic events, but middle-and long-term results should be clarified.