Please use this identifier to cite or link to this item:
|Title:||A new paradigm in the management of acute type A aortic dissection: Total aortic repair.||Austin Authors:||Matalanis, George ;Ip, Shoane P||Affiliation:||Department of Cardiac Surgery, Austin Health, Heidelberg, Victoria, Australia||Issue Date:||Jan-2019||metadata.dc.date:||2018-10-13||Publication information:||The Journal of thoracic and cardiovascular surgery 2019; 157(1): 3-11||Abstract:||The currently accepted guidelines of open surgical repair for acute type A aortic dissection include the resection of the primary entry tear, replacement of the ascending aorta and "hemi-arch" with an open distal anastomosis, and aortic valve resuspension and some form of obliteration of the aortic root false lumen. The principal aim is protection against aortic rupture, aortic regurgitation, and coronary ischemia and restoration of antegrade preferential true lumen perfusion. Proponents argue that this operation is tailored to be in the armamentarium of most cardiac surgeons and deliver the lowest early operative risk while leaving the infrequent long-term sequelae to be dealt with electively by experienced aortic centers. Although this may sound to be a compelling argument, the actual outcomes suggest that it falls significantly short of achieving its noble goals on both acute and chronic counts. This led us to develop a seemingly more radical paradigm, which aims to achieve total aortic healing in the acute phase. We describe a total aortic repair technique for acute type A aortic dissection consisting of "branch first" total arch repair, followed by thoracoabdominal stenting and balloon rupture of the septum. The total aortic repair technique ensures that the aortic valve, ascending aorta, and arch are surgically securely repaired, and provides complete decompression of the false lumen as well as internal support in the remainder of the aorta. This has provided excellent early results and will hopefully minimize future complications and interventions.||URI:||http://ahro.austin.org.au/austinjspui/handle/1/20030||DOI:||10.1016/j.jtcvs.2018.08.118||Journal:||The Journal of thoracic and cardiovascular surgery||PubMed URL:||30557944||Type:||Journal Article||Subjects:||abdominal stenting
aortic arch repair
|Appears in Collections:||Journal articles|
Show full item record
checked on Jan 26, 2023
Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.