Open aortic septectomy for complicated type B aortic dissection.

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Thoracic Surgery

Background:

• Acute aortic dissection (AAD) frequently causes malperfusion, significantly increasing patient morbidity and mortality.
• Endovascular repair of the intimal tear often resolves distal malperfusion by reexpanding the true lumen.
• Persistent or delayed malperfusion necessitates further interventions when endovascular approaches are insufficient or not feasible.

Observation:

• This report details two cases of complicated AAD with partial false lumen thrombosis.
• Both patients presented with malperfusion syndromes refractory to standard endovascular treatments.
• Open aortic septectomy was performed as an alternative therapeutic strategy.

Findings:

• Open aortic septectomy successfully treated malperfusion in both described cases.
• The procedure involved surgically creating a fenestration to improve true lumen flow.
• This case series highlights the efficacy of septectomy in complex AAD scenarios.

Implications:

• Open aortic septectomy represents a critical alternative for patients with complex malperfusion due to AAD who lack suitable endovascular options.
• This technique expands the therapeutic armamentarium for managing challenging aortic dissection complications.
• Further research into the indications and outcomes of open septectomy is warranted for refining AAD treatment algorithms.