Rapid false lumen dilation and pseudocoarctation due to inadvertent preferential false lumen perfusion using the frozen elephant trunk technique in a chronic residual aortic dissection

Rapid false lumen dilation and pseudocoarctation due to inadvertent preferential false lumen perfusion using the frozen elephant trunk technique in a chronic residual aortic dissection

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A patient with a chronic postdissection distal arch aneurysm was treated with total Visor Cap arch replacement and frozen elephant trunk.Following uneventful initial recovery, the frozen elephant trunk appeared to be inadvertently perfusing the false lumen through an already present (in retrospect) intimal tear, resulting in rapid dilation of the false lumen and proximal compression of the graft.Treatment consisted, first, INCENSE AMBER of endovascular redirection of flow toward the distal true lumen and, second, open surgical repair of the remaining type IV aneurysm.

This case underlines the importance of scrutinizing preoperative imaging for correct use of the frozen elephant trunk.Keywords: Aortic dissection, Frozen elephant trunk, Aortic arch, TEVAR.