Single stage thoracic aortic replacement and aortic valve replacement via clamshell thoracotomy.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• Aortic arch anomalies can complicate standard aortic surgery.
• Acute aortic dissection presents unique surgical challenges, especially with associated aneurysms and aberrant vessels.

Observation:

• This tutorial describes a single-stage surgical approach for aortic arch dissection.
• The technique involves aortic valve replacement and thoracic aorta replacement using a clamshell thoracotomy.

Findings:

• The described procedure utilizes a single quadrifurcated tube graft.
• This method requires only brief partial hypothermic circulatory arrest, minimizing surgical insult.

Implications:

• This technique offers a potentially less invasive and more efficient option for complex aortic arch pathologies.
• It may reduce operative time and complications associated with prolonged hypothermic circulatory arrest in aortic surgery.