"Branch-First total arch replacement": a valuable alternative to frozen elephant trunk in acute type A aortic dissection?

2022-04

Kim, Michelle

Matalanis, George

Acute aortic dissection

Antegrade cerebral perfusion

Aortic arch replacement

Branch-First

Frozen elephant trunk

Total aortic arch repair

Journal Article

0000-0002-5176-3361

10.1007/s12055-021-01279-x

The "Branch-First total arch replacement" technique has been used extensively in both elective and acute situations, including in type A aortic dissection. The focus of the Branch-First technique is to reduce the risk of neurological and end-organ dysfunction associated with arch replacement by optimising neuroprotection, distal organ perfusion and myocardial protection. The Branch-First technique is a valuable alternative to the frozen elephant trunk (FET) technique in type A aortic dissection, providing a stable landing zone for subsequent interventions on the distal aorta should they be required. Combining the Branch-First technique with FET in appropriate cases can further improve outcomes. We discuss the merits of the Branch-First technique, and contrast them to those of FET techniques for repair of type A aortic dissection.

link

Indian Journal of Thoracic and Cardiovascular Surgery 2022; 38(Suppl 1): 58-63

Indian Journal of Thoracic and Cardiovascular Surgery

0970-9134