Surgical treatment of a retrograde Type-A-dissection by means of an integrated stent graft-dacron prosthesis

A 60-year-old woman presented with sudden severe pain in the interscapular region and a feeling of impending death in the emergency room. She had a medical history of hypertension, hypercholesterolemia and strong tobacco abuse. The results of the CT-scan showed an extensive thoracic aortic dissection with an entry distal to the origin of the left subclavian artery reaching retrograde to the left coronary ostia as well as antegrade into the upper abdomen aorta. Here, we describe the surgical treatment of this retrograde Type A dissection combining an open ascending tube graft and aortic arch replacement with simultaneous antegrade deployment of an endoluminal graft (E-VITA open (R)) into the descending thoracic aorta as an one-stage repair.