CTICasesAortic dissection
Imaging findings
Contrast-enhanced CT scans post-ascending aortic dissection repair show a dilated aortic root, persistent false lumen filling, and a subsequent multi-stage repair including a carotid-to-subclavian bypass, proximal subclavian plugging, aortic root/ascending replacement with a Valsalva graft, a floppy/redundant elephant trunk graft in the proximal descending aorta, and subsequent endovascular stent placement (TEVAR) landing within the elephant trunk graft.
Key takeaways
Staged repair of complex aortic dissections or aneurysms involving both the ascending and descending aorta is facilitated by the elephant trunk technique. The initial open procedure leaves a redundant graft segment in the proximal descending aorta, which provides a secure landing zone for subsequent endovascular stent grafts (TEVAR) to seal the false lumen.
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