Novel endovascular management of proximal type A (DeBakey II) aortic dissection with a patent foramen ovale occluder
Author(s)
Yuan, Xun
Mitsis, Andreas
Mozalbat, David
Nienaber, Christoph A
Type
Journal Article
Abstract
Purpose: To present a novel endovascular management option that avoids open surgery in selected patients with subacute type A aortic dissection (DeBakey II). Case Report: A 75-year-old woman with previous infrarenal abdominal aortic aneurysm repaired in 2006 and multiple comorbidities (EURO score II 20.5%) was admitted with chest pain; computed tomography angiography (CTA) showed a new dissection in the ascending aorta just above the right coronary ostium. As the patient was considered unfit to undergo surgery, an endovascular solution was suggested after multidisciplinary team discussion. With a single entry identified, coils were deployed in the false lumen followed by a patent foramen ovale (PFO) occluder placed across the entry tear to seal the cavity. Intraprocedural digital subtraction angiography and transesophageal echocardiography, as well as CTA 3 days postprocedure, confirmed an entirely thrombosed false lumen. The 6-month follow-up CTA demonstrated the PFO occluder firmly in place, shrinkage of the false lumen, and remodeling of the ascending aorta. Conclusion: Interventional management of the false lumen in proximal (type A) dissection is feasible and sustainable. The use of coils and closure devices may present a new, efficient, minimalistic strategy to avoid open surgery in selected cases.
Date Issued
2017-12-01
Date Acceptance
2017-05-31
Citation
Journal of Endovascular Therapy, 2017, 24 (6), pp.809-813
ISSN
1526-6028
Publisher
SAGE Publications
Start Page
809
End Page
813
Journal / Book Title
Journal of Endovascular Therapy
Volume
24
Issue
6
Copyright Statement
© The Author(s) 2017. The final, definitive version of this paper has been published in Journal of Endovascular Therapy by Sage Publications Ltd. All rights reserved. It is available at: https://journals.sagepub.com/doi/10.1177/1526602817725061
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000415166500008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Surgery
Peripheral Vascular Disease
Cardiovascular System & Cardiology
coil embolization
endovascular repair
proximal aortic dissection
type A/DeBakey II dissection
PFO occluder
vascular plug
PERSISTENT FALSE LUMEN
INTERNATIONAL REGISTRY
SURGERY
REPAIR
EMBOLIZATION
INSIGHTS
IRAD
Publication Status
Published
Date Publish Online
2017-12-01