Patients suffering retrograde type A dissection after TEVAR for type B
dissection are at a higher risk of mortality than their spontanous
counterparts and the kind of optimal therapy remains obscure. We present
a rare case of successful open surgical repair where distal open
anastomosis was accomplished cutting off the un-covered stent portion
and suturing a vascular prosthesis to the dissected distal aortic arch
including the covered stent part. The clinical course was regular.
Immediate and radical repair in the aortic arch may be the adequate
response in such instances.