[Efficacy of antero-lateral thoracotomy with partial sternotomy for type B aortic dissection after ascending aortic...

The patient was a 41-year-old man. He had undergone ascending aortic replacement due to type A acute aortic dissection 3 years before. He was diagnosed with de novo type B aortic dissection, and therefore given conservative treatment. Extension of the false lumen was detected in the discending aorta (56 mm in diameter). Computed tomography (CT) showed that discending aortic dissection had 4 lumens and their entries were not clear. Under selective cerebral extracorporeal circulation, we performed ascending-arch-descending aortic replacement using antero-lateral thoracotomy with partial sternotomy (ALPS method). He was discharged on the postoperative day 16. In conclusion, ALPS method guarantees wider surgical field and is useful for diffuse thoracic aortic disease, especially for aortic dissection with obscure entry which needs broad aortic replacement.