Journal
ANNALS OF CARDIOTHORACIC SURGERY
Volume 5, Issue 3, Pages 236-244Publisher
AME PUBL CO
DOI: 10.21037/acs.2016.05.11
Keywords
Aorta; dissection; endovascular techniques
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Acute type A dissection (ATAAD) remains a morbid condition with reported surgical mortality as high as 25%. We describe our surgical approach to ATAAD and discuss the indications for adjunct techniques such as the frozen elephant trunk or complete aortic repair with endovascular methods. Arch replacement using the branch-first technique allows for complete root, ascending aorta, and arch replacement. A long landing zone is created for proximal endografting with a covered stent. Balloon-assisted intimal disruption and bare metal stenting of all residual dissected aorta to the level of the aortic bifurcation is then performed to obliterate the false lumen (FL) and achieve single true lumen (TL) flow. Additional branch vessel stenting is performed as required.
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