Harky Amer, Fisher Robert K, Field Mark L
Thoracic Aortic Aneurysm Service, Liverpool Centre for Cardiovascular Sciences, 156669Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.
Department of Vascular and Endovascular Surgery, 159020Royal Liverpool University Hospital, Liverpool, United Kingdom.
Vasc Endovascular Surg. 2020 Nov;54(8):756-759. doi: 10.1177/1538574420949313. Epub 2020 Aug 13.
To report a case who required a thoracic endovascular stenting (TEVAR) following the deployment of frozen elephant trunk due to false lumen expansion.
A 47 years old male patient undergone emergency repair of acute type A aortic dissection in 2011 with bioprosthetic aortic root conduit. Seven years later he presented with moderate aortic valve disease and expanding chronic dissection of the aortic arch, therefore a redo operation with replacement of the prosthetic aortic valve, ascending aorta, total arch and deployment of frozen elephant trunk and he was discharged in good health. Several days post discharge he presented with new onset of chest pain and a new dissection involved the thoracoabdominal aorta was noted pressing on the true lumen and the frozen elephant trunk. Following a multi-disciplinary team meeting, TEVAR was deemed as a most appropriate approach and this was achieved successfully, and patient was discharged. At 1 year of follow up, he remains well and asymptomatic.
Close imaging follow-up following deployment of a FET is mandatory. A new acute Type B aortic dissection distal to the FET, that causes false lumen propagation parallel to the stented portion, is a surgical emergency and further intervention mandated.
报告一例因假腔扩张在植入冰冻象鼻支架后需要进行胸主动脉腔内支架置入术（TEVAR）的病例。
一名47岁男性患者于2011年接受了生物人工主动脉根部导管的急性A型主动脉夹层急诊修复术。七年后，他出现中度主动脉瓣疾病和主动脉弓慢性夹层扩张，因此进行了再次手术，置换人工主动脉瓣、升主动脉、全弓并植入冰冻象鼻支架，术后健康出院。出院几天后，他出现新发胸痛，发现新的夹层累及胸腹主动脉，压迫真腔和冰冻象鼻支架。经过多学科团队会诊，TEVAR被认为是最合适的治疗方法并成功实施，患者出院。随访1年时，他情况良好且无症状。
植入FET后必须进行密切的影像学随访。FET远端新发生的急性B型主动脉夹层，导致假腔沿支架部分平行扩展，是外科急症，需要进一步干预。
