Descending aortic banding for re-rupture of retrograde aortic dissection after emergency thoracic endovascular aortic repair

• DOI: 10.1007/s11748-018-1016-9
• Publication Date: 2018-09-22T07:58:35Z
• Authors: Shigeru Hattori; Kenichiro Noguchi; Yusuke Gunji; Motoki Nagatsuka; Tsuyoshi Yamabe; Hidemitsu Ogino; Ikuo Katayama
• Keywords: Descending aorta; Thoracotomy; Thoracic aorta; Aortic repair; Aortic rupture

Conversion to open repair after thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection is rare, but inevitable. We present a case of an 86-year-old man with ruptured type B aortic dissection after TEVAR. He received a successful stent-graft implantation of the descending aorta without any type of endoleak. After the patient was transferred to the intensive care unit, he went into a shock state. Contrast-enhanced CT revealed a re-rupture of acute retrograde type B aortic dissection. The false lumen was patent and perforated to the left thorax. Left thoracotomy and descending aortic banding was performed. Descending aorta was encircled with a woven Dacron graft at the distal part of the rupture site to compress the patent false lumen. The bleeding was stopped, and the follow-up CT showed false lumen thrombosis. Descending aortic banding is one of the quick and effective open conversion techniques.