A 67-year-old patient with severe comorbidities and acute type A aortic dissection with pericardial tamponade was treated with an endograft introduced through a mini-thoracotomy and puncture of the left ventricular apex. Final angiography showed complete coverage of the dissection. Early and 6-month follow-up computed tomography showed full apposition of the endograft without residual dissection. Transapical thoracic endovascular repair of acute type A aortic dissection appears to be feasible and is associated with minimal physiologic compromise. It may provide a less invasive alternative for patients with increased operative mortality.
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