Case Report: Endovascular repair for true lumen collapse after frozen elephant trunk for type A aortic dissection
- 1Department of Cardiovascular Surgery, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
Abstract
Introduction: Frozen elephant trunk (FET) was applied in the treatment of type A aortic dissection, enabling one-stage repair of the aortic arch and proximal descending aorta while promoting true lumen expansion. However, inadvertent FET deployment into the false lumen is a rare but catastrophic complication that may cause true lumen collapse and life-threatening visceral malperfusion, with limited reports on its endovascular management.
Case presentation: Here, we present the case of a 44-year-old female who underwent Bentall procedure, total arch replacement, and FET implantation for acute type A aortic dissection at a local hospital. Postoperatively, she developed visceral malperfusion manifesting as abdominal distension, hepatic and renal dysfunction, and elevated lactate levels. Computed tomography angiography revealed that the FET stent had been inadvertently deployed into the false lumen, resulting in true lumen collapse. Emergency thoracic endovascular aortic repair was performed, establishing a “FET-false lumen-true lumen” pathway with an additional stent graft to redirect aortic flow into the true lumen. Computational fluid dynamics analysis showed that the postoperative hemodynamics have been significantly improved. The patient's organ function normalized, and she was discharged two weeks later, remaining asymptomatic at 8-month follow-up.
Conclusion: Endovascular reintervention with additional stent grafting to establish a flow-redirection pathway is a feasible and effective strategy for true lumen collapse following inadvertent FET deployment into the false lumen. Prompt recognition, timely imaging confirmation, and immediate intervention are paramount to mitigating the risks associated with this serious complication.
Related
- Early-term and midterm outcomes of endovascular completion of high-risk subacute and early chronic residual dissection after type A repair
- Situs Inversus Totalis with Mirror-Image Dextrocardia and Acute Type A Aortic Dissection Treated by Ascending Aorta Replacement Plus Total Arch Replacement and Frozen Elephant Trunk Using an Inverted Four-Branched Graft: A Case Report
- Perspectives on Thoracic Endovascular Aortic Repair for Uncomplicated Type B Aortic Dissection: An International Survey Within the SUNDAY Network
- Case Report: staged segment-specific open and endovascular treatment of chronic post-dissection aortic disease with descending thoracic and giant infrarenal aneurysmal components
- Case Report: Brucella-associated complications following thoracic endovascular aortic repair: a case series of three patients
BibTeX
@article{fan2026case,
title = {{Case Report: Endovascular repair for true lumen collapse after frozen elephant trunk for type A aortic dissection}},
author = {Xiaoping Fan and Kunyang He and Wenliu Xu and Zengxiao Zou and Naijimuding Abudurexiti and Ge Wang and Chaojie Wang},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1961251},
url = {https://doi.org/10.3389/fcvm.2026.1961251},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: Endovascular repair for true lumen collapse after frozen elephant trunk for type A aortic dissection
AU - Xiaoping Fan
AU - Kunyang He
AU - Wenliu Xu
AU - Zengxiao Zou
AU - Naijimuding Abudurexiti
AU - Ge Wang
AU - Chaojie Wang
PY - 2026
DA - 2026/10/12
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1961251
UR - https://doi.org/10.3389/fcvm.2026.1961251
AB - Introduction: Frozen elephant trunk (FET) was applied in the treatment of type A aortic dissection, enabling one-stage repair of the aortic arch and proximal descending aorta while promoting true lumen expansion. However, inadvertent FET deployment into the false lumen is a rare but catastrophic complication that may cause true lumen collapse and life-threatening visceral malperfusion, with limited reports on its endovascular management. Case presentation: Here, we present the case of a 44-year-old female who underwent Bentall procedure, total arch replacement, and FET implantation for acute type A aortic dissection at a local hospital. Postoperatively, she developed visceral malperfusion manifesting as abdominal distension, hepatic and renal dysfunction, and elevated lactate levels. Computed tomography angiography revealed that the FET stent had been inadvertently deployed into the false lumen, resulting in true lumen collapse. Emergency thoracic endovascular aortic repair was performed, establishing a “FET-false lumen-true lumen” pathway with an additional stent graft to redirect aortic flow into the true lumen. Computational fluid dynamics analysis showed that the postoperative hemodynamics have been significantly improved. The patient's organ function normalized, and she was discharged two weeks later, remaining asymptomatic at 8-month follow-up. Conclusion: Endovascular reintervention with additional stent grafting to establish a flow-redirection pathway is a feasible and effective strategy for true lumen collapse following inadvertent FET deployment into the false lumen. Prompt recognition, timely imaging confirmation, and immediate intervention are paramount to mitigating the risks associated with this serious complication.
SN - 2297-055X
ER -