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Title: Surgical management of acute type A aortic dissection: branch-first arch replacement with total aortic repair
Austin Authors: Galvin, Sean D;Perera, Nisal K;Matalanis, George 
Affiliation: Department of Cardiothoracic Surgery, Wellington Regional Hospital, Wellington, New Zealand
Department of Cardiac Surgery, Austin Health, Heidelberg, Victoria, Australia
Issue Date: May-2016
Publication information: Annals of Cardiothoracic Surgery 2016; 5(3): 236-244
Abstract: 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.
DOI: 10.21037/acs.2016.05.11
PubMed URL:
Type: Journal Article
Subjects: Aorta
Endovascular techniques
Appears in Collections:Journal articles

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