Full metal jacket for complicated type A aortic dissection: complex hybrid surgery management.

Abstract

We report a patient affected by complicated retrograde type A aortic dissection (DeBakey type I) with false lumen rupture and acute right lower limb ischemia treated with fenestration at the aortic bifurcation followed by a hybrid approach, consisting of an elephant trunk procedure and the placement of endoluminal stent graft for the treatment of descending thoracic aorta dissection. In our patient, in spite of the closure of the primary entry site, false lumen failed to remodel in the abdominal aorta, therefore the positioning of the bare stents and aortobisiliac endoprosthesis of the abdominal aorta were performed. Visceral blood flow was preserved and the postoperative course was uneventful at the 6-month follow-up.