Background:

To report the initial experience performing thoracic endovascular aortic repair thoracic aortic endovascular repair (TEVAR) with double chimney in patients with aortic dissection (Stanford A) which had previous emergency open surgery, with replacement of ascending aorta and valve replacement.

Material and methods:

A series of 6 consecutive cases is reported from August 2017 to August 2019 managed with TEVAR with double chimney. All patients were followed up at 1, 6 and 12 months.

Results:

In all cases a C-TAG stent graft was used, five innominate arteries were treated using a Viabahn and one case with excluder iliac extension. All the left common carotid arteries were treated with Viabahn. There was no post-surgical mortality, the overall mortality was 16%. There was a Type I endoleak detected during surgery, treated with balloon dilation. Hematoma occurred in 50% and one patient developed post implant syndrome. No endoleak were identified during follow up at 6 and 12 months. At 12 months there is an overall mortality of 16%.

Conclusion:

Double chimney technique is an alternative with lower morbidity and mortality compared to open surgery in patients with previous ascending aortic surgery. However, further experience and long term follow up is necessary to confirm its long-term safety and efficacy.

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