Experience and early outcome of treating retrograde type A dissection with primary entry tear in the descending thoracic aorta

Once the ascending aorta gets involved and however farther the dissection extends, it is named type Adissection （TAD）, in which the entry tear usually locates in the ascending aorta. But there exists a small subset with primary entry tear in the descending aorta and the dissection process extends back into the ascending aorta, which here we name primary retrograde type A dissection （PRTAD）. Operative procedures are far more difficult and extensive for PRTAD and usually result in poor prognosis in the aspects of surgical mortality and survival rate during follow-up.1-3 Kato et al4 and Chang et al5 showed successful method of endovascular repair for PRTAD and recommended it as an alternative to the operative treatment. During March 2008 to August 2010, five continuous patients with PRTAD were admitted into our institution. We here introduce our preliminary experience with medical therapy and thoracic endovascular aortic repair （TEVAR） for treating PRTAD.