SPONTANEOUS RETROGRADE DISSECTION OF THE ENTIRE THORACIC AORTA ORIGINATING IN THE ABDOMINAL-AORTA - CASE-REPORT AND REVIEW OF THE LITERATURE

Spontaneous retrograde thoracic extension of the abdominal aortic diss ection is extremely rare and difficult to manage. Only five cases have been previously reported in the English literature (dissection reachi ng the ascending aorta in four, dissection limited in the descending t horacic aorta in one), and all the cases of dissection which reached t he ascending aorta were lethal. We herein report one case of a 37-year -old man who was operated on for spontaneous retrograde dissection of the entire thoracic aorta originating in the suprarenal abdominal aort a. Preoperative aortogram revealed the site of the intimal tear just a bove the celiac artery. He urgently underwent graft replacement of the descending thoracic aorta and the abdominal aorta with reimplantation of the thoracoabdominal visceral arteries. Although the patient had t o undergo the second operation for the dissection of the remaining tho racic aorta four months postoperatively, he has been doing well 18 mon ths after the second operation.