Key result
Bail-out TEVAR successfully salvages false-lumen frozen elephant trunk deployment, enabling discharge at day 67.
Why the study?
Incorrect deployment of a frozen elephant trunk into the false lumen during aortic dissection repair is a rare complication requiring effective bail-out strategies.
Case Report (n=1)
No
Bail-out TEVAR using a re-entry device can successfully rescue incorrect deployment of a frozen elephant trunk into the false lumen.
Answers are grounded in this paper and cite their sources.
Suggests bail-out TEVAR as rescue for FET false-lumen deployment; hypothesis-generating and needs validation in larger series.
We report a rare case of bail-out thoracic endovascular aortic repair after incorrect deployment of a frozen elephant trunk into the false lumen. A 54-year-old man presented to our department complaining of chest pain. Enhanced computed tomography revealed Stanford type A acute aortic dissection, which had a large entry site at the mid-descending aorta. Emergency total aortic arch replacement with a frozen elephant trunk was performed. Progressive intraoperative acidosis was observed. Immediate postoperative enhanced computed tomography showed that the distal end of the frozen elephant trunk was deployed into the false lumen through the initial tear at the proximal descending aorta. We performed emergency thoracic endovascular aortic repair through a fenestration made into the intimal flap using an Outback LTD re-entry device. The patient was discharged home on postoperative day 67 after a complete recovery.
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Kawashima et al. (2020) conducted a case report in Stanford type A acute aortic dissection (n=1). Bail-out thoracic endovascular aortic repair was evaluated on Patient recovery and discharge. Bail-out thoracic endovascular aortic repair successfully salvaged a patient after incorrect deployment of a frozen elephant trunk into the false lumen, allowing discharge on postoperative day 67.
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