Complex endovascular repair of a large dissection of the ascending aorta in a 70-year-old man.

We report the case of a 70-year-old man who presented with a large dissection of the ascending aorta related to coronary artery bypass grafting 3 years earlier. One graft was patent; however, a reverse venous graft to the right coronary artery was occluded, and that artery was substantially stenotic. The patient was a high-risk surgical candidate, so we treated a large dissection successfully by endovascular means with a thoracic endograft. This case suggests that this approach can be applied safely and effectively to other high-surgical-risk patients who have complex ascending aortic disease.