Acute Type A Aortic Dissection Causing Collapse of Previous Stent Graft

A 69-year-old man presented to the emergency department with back pain and paraplegia. Computed tomography showed acute type A aortic dissection with a primary tear right below the origin of the left subclavian artery. He had undergone endovascular aneurysm repair 13 months earlier, and the previously inserted endovascular graft had totally collapsed. Total arch replacement covering the primary entry tear was performed. Femoral pulse was undetected before the operation but was monitored postsurgically after cardiopulmonary bypass was weaned. The patient was discharged from the hospital on foot without an additional intervention.