Transfemoral uncovered stent to treat iatrogenic type A dissection during transcatheter aortic valve implantation

A 91-year-old female was referred to our institution for transfemoral transcatheter aortic valve implantation (TAVI). Under general anaesthesia, a 25-mm fully retrievable and re-positionable prosthesis (Direct Flow Medical®) was implanted. A control aortography confirmed perfect positioning and functioning of the prosthetic valve with aortic dissection extending from the ascending aorta to the aortic arch and the distal thoracic aorta ( Panels A – C ). We decided to manage the condition in an endovascular fashion implanting, transfemorally, a 32-130-28 mm self-expandable uncovered single flared stent (E-XL®, JOTEC GmbH, Hechingen, …