# Percutaneous Treatment of Type A Aortic Dissection Using Atrial Septal Defect Occlusion Device

## TL;DR

This paper describes a new percutaneous method using heart defect devices to treat a rare type of aortic dissection in a high-risk patient.

## Contribution

The first reported use of a false lumen-to-true lumen approach with atrial septal defect occlusion devices for type A aortic dissection.

## Key findings

- Endovascular treatment using two self-expandable atrial septal defect occlusion devices was successfully applied.
- Intracardiac echocardiography provided better visualization than transesophageal echocardiography during the procedure.
- The approach avoided major surgery in a high-risk patient with multiple comorbidities.

## Abstract

Endovascular techniques are commonly employed for type B aortic dissections and are rarely reported for type A dissections. We present the case of a 78-year-old female diagnosed with a type A aortic dissection, with coronary arteries and supra-aortic vessels perfused from the true lumen and no significant aortic valve dysfunction. Given her recent cardiovascular surgery, the anticipated prolonged recovery, and multiple comorbidities, a percutaneous approach was preferred, with classical surgery available as stand by. The patient underwent endovascular treatment using two self-expandable, double-disc atrial septal defect occlusion devices. Intracardiac echocardiography facilitated device deployment, offering superior visualization compared with transesophageal echocardiography, which can be partially obscured by the left pulmonary artery. To our knowledge, the false lumen-to-true lumen approach in percutaneous management of type A aortic dissection has not been previously described.