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Ann Thorac Surg 2006;82:1523-1525
© 2006 The Society of Thoracic Surgeons

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Case Reports

Iatrogenic Type A Dissection After Attempted Stenting of a Descending Aortic Aneurysm

^a Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
^b Division of Radiology, Hannover Medical School, Hannover, Germany

Accepted for publication February 2, 2006.

^_* Address correspondence to Dr Zhang, Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany (Email: zhang.ruoyu{at}mh-hannover.de).

This case demonstrates an iatrogenic acute retrograde type A dissection of the aortic arch and ascending aorta during elective endovascular stenting of a proximal descending aortic aneurysm. This devastating complication necessitated emergent surgery with unfavorable postoperative outcome. Other than the known causes, the described retrograde type A dissection resulted from guidewire manipulation and iatrogenic creation of a false lumen, which was erroneously dilated and stented.