Resternotomy Plus Left Thoracotomy Surgery after Previous Acute Type A Aortic Dissection Repair

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Dissection Research

Background:

• Improved outcomes in acute type A aortic dissection repair necessitate focus on late reoperations.
• Residual dissection after initial repair presents a growing clinical challenge.

Purpose of the Study:

• To evaluate the safety and efficacy of extended surgical approaches for late reoperation in patients with residual dissection after acute type A aortic dissection repair.

Main Methods:

• Retrospective analysis of 17 patients undergoing reoperation via extended approaches (repeat median sternotomy plus left thoracotomy).
• Study conducted at Matsubara Tokushukai Hospital, Japan, from April 2003 to September 2016.

Main Results:

• Zero postoperative stroke rate observed.
• In-hospital mortality rate was 5.9%.

Conclusions:

• Extended surgical approaches are a viable option for reoperation after acute type A aortic dissection repair.
• These methods yield acceptable clinical outcomes in managing residual dissection.