Painless retrograde type A aortic dissection followed conservative treatment of type B aortic dissection: a case report

Yongle Ruan,Zhiyong Wu,Anfeng Yu,Zongli Ren,Wei Ren,Zhiwei Wang,Mohamed Rahouma

doi:10.1186/s12872-020-01331-5

Abstract

BackgroundRetrograde type A aortic dissection (RTAD) is a fatal aortic disease secondary to descending aortic dissection, and might be misdiagnosed due to its atypical symptoms lead to catastrophic outcomes.Case presentationWe herein reported a case of a 40-year old Chinese non-comorbid man who received conservative treatment for acute type B aortic dissection and progressed to RTAD in a painless manner in a week. After open surgical aortic repair with stented elephant truck technique, the patient survived without obvious complication and cured with a satisfactory outcome in a half-year follow-up.ConclusionThis case indicates that RTAD may present without typical symptoms, early diagnosis and open surgical procedure are imperative for treating RTAD.

Highlights

Retrograde type A aortic dissection (RTAD) is a fatal aortic disease secondary to descending aortic dissection, and might be misdiagnosed due to its atypical symptoms lead to catastrophic outcomes
Thoracic endovascular aortic repair (TEVAR) has been used with increasing frequency for management of type B aortic dissection, as it is less invasive and associated with a lower complication rate compared to traditional surgical repair
RTAD can be triggered in the fragile aortic wall of acute type B aortic dissection in thoracic endovascular aortic repair (TEVAR) procedure, and it is a fatal complication with up to 42%

Summary

Introduction

Retrograde type A aortic dissection (RTAD) is a fatal aortic disease secondary to descending aortic dissection, and might be misdiagnosed due to its atypical symptoms lead to catastrophic outcomes. Thoracic endovascular aortic repair (TEVAR) has been used with increasing frequency for management of type B aortic dissection, as it is less invasive and associated with a lower complication rate compared to traditional surgical repair. Endovascular treatment of type B aortic dissections presented a lower in-hospital mortality rate (10.6%) compared to that of patients under open surgical repair (33.9%) [2].

Results

Conclusion