REVIEW  RECENT DEVELOPMENTS IN THE MANAGEMENT OF AORTIC DISSECTIONS 

The Journal of Cardiovascular Surgery 2018 December;59(6):759-66

DOI: 10.23736/S0021-9509.18.10646-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Techniques and outcomes of secondary open repair for chronic dissection after acute repair of type A aortic dissection

Roland ASSI, Joseph E. BAVARIA, Nimesh D. DESAI ✉

Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA

Despite successful repair of acute type A aortic dissection (TAAD), the distal false lumen may remain patent resulting in progressive degeneration of the remaining distal aorta. This can lead to aneurysmal dilatation and risk of rupture. Open distal reoperation to replace the residually dissected thoraco-abdominal aorta may be accomplished with acceptable morbidity and mortality in experienced hands. This can be facilitated when the index operation for acute TAAD is tailored to exclude all primary tears and set the arch and descending aorta for a subsequent open, endovascular or hybrid procedure.

KEY WORDS: Aneurysm, dissecting - Aorta, thoracic - Endovascular procedures