Thoracoabdominal aortic aneurysms developing in the chronic phase of an aortic dissection
require multidisciplinary approach, experienced operators and advanced technology.
The mortality and morbidity rate of these multistage operations were reduced with
the latest technical achievements in endovascular repair, but they are still significant.
Fenestrated endovascular aortic repair, an alternative of thoracoabdominal open repair,
is associated with less mortal-ity and morbidity, shorter hospital stay. Using fenestrated
devices in aortic dissection is usually technically demanding due to the dissection
membrane. We report the case of a 56-year-old woman, who underwent ascending aortic
repair due to type A aortic dissection. During the follow-up, a large thoracoabdominal
aneurysm developed involving also the arch. We performed a three-stage operation starting
with the open repair of the aortic arch using a 'frozen ele-phant trunk' device followed
by a thoracic endovascular aortic repair of the descending aorta. The final stage
was a fenestrated endovascular aortic repair, which is the first use of this technique
in aortic dissection in Hungary.
