Zone 0 Thoracic Endovascular Aortic Repair Using Reverse Extra-Anatomical Aortic Arch Debranching Technique for an Anastomotic Pseudoaneurysm and Acute Aortic Dissection that Developed after Bentall’s Surgery Combined with Sjögren’s Syndrome

A 66 year-old man with a previous history of Sjögren’s syndrome was admitted with anastomotic pseudoaneurysm and aortic dissection in the ascending aorta, which developed after Bentall’s surgery, a procedure that has severe complications and high mortality. Using the reverse extra-anatomical aortic arch debranching technique, zone 0 thoracic endovascular aortic repair was performed emergently. The postoperative course was uneventful. Twenty months later, computed tomography showed remodeling of the dissection, resolution of the pseudoaneurysm, and patency of the reverse extra-anatomical aortic arch debranching graft.