Unexpected, complete recovery after emergent thoracic endovascular aortic repair for inoperable type A aortic dissection

Patients presenting with a Stanford type A acute aortic dissection require immediate surgical treatment; however, up to 30% of patients are deemed inoperable. Here we describe a case of a patient with a complicated type A acute aortic dissection presenting with a severe impact of brain malperfusion. In contrast with open surgery, an emergent thoracic endovascular aortic repair was performed with a Gore cTAG 45 × 150 mm graft and an additional chimney graft Advanta V12 7 × 59 mm graft for the brachiocephalic trunk. After early extubation, unexpected complete neurological recovery was observed. A follow-up computed tomography scan demonstrated complete remodeling of the ascending aorta. This report underlines the potential of thoracic endovascular aortic repair as an alternative for immediate open surgical repair in case of high-risk or inoperable patients.