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Aortic surgery

New developments and perspectives


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The pioneering efforts of Dubost, Cooley, Crawford, DeBakey, Dake et al. have been characterized by remarkable and sustained progress in the surgery of the aorta. Thanks to their efforts, today surgeons can better assess operative risk and greatly reduce operative morbidity and mortality.
The exciting potential of endoluminal grafting for aneurysmal disease and dissection is yet to be fully realized despite dramatic and rapid development. Endovascular repair of infrarenal and isolated thoracic aneurysms has proven beneficial with decreased operative morbidity and mortality and durable long term results.
The use of supraortic trunks or visceral/renal vessels debranching to create a proximal or distal landing zone for subsequent TEVAR has been advocated to minimize the extent of surgery for thoracic aorta repair.
Total endovascular repair of thoracoabdominal aneurysms remains in its infancy with very little experience accrued to date; however, given improvements in technology, proven durability and widespread applicability, it is likely to eventually play a more significant role in the care of such patients.
The molecular and genetic underpinnings of arterial disease are just know being productively explored.
Last but not least, we are now embarking on a new era in the treatment of valvular heart disease with the introduction of percutaneous and minimally invasive devices and techniques to address valve dysfunction without conventional surgical repair.

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