Complex acute dissection of the aortic arch--a novel hybrid concept for one stage surgical repair

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Acute aortic dissection is a life-threatening condition affecting the aorta.
• DeBakey type I involves the aortic arch and descending aorta, while type II is limited to the ascending aorta.
• Standardized surgical approaches are insufficient for complex aortic arch dissections or those with malperfusion/hemodynamic compromise.

Purpose of the Study:

• To present the Essen treatment concept for complicated acute aortic arch dissection.
• To outline diagnostic and operative strategies for complex cases.
• To provide a comprehensive approach from diagnosis to surgical intervention.

Main Methods:

• Review of diagnostic modalities for acute aortic arch dissection.
• Analysis of surgical strategies for complex aortic arch dissection.
• Presentation of the Essen treatment algorithm.

Main Results:

• The Essen concept offers a structured approach to managing complex acute aortic arch dissections.
• Specific diagnostic and operative techniques are detailed for various scenarios.
• The review highlights the importance of tailored strategies for malperfusion and hemodynamic instability.

Conclusions:

• The Essen treatment concept provides a standardized yet adaptable strategy for complicated acute aortic arch dissections.
• Effective management requires precise diagnostics and individualized surgical planning.
• This approach aims to improve outcomes in high-risk aortic dissection patients.