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Extended Cervical Access for Cerebral Malperfusion in Acute Aortic Dissection in a Circulatory Unstable Patient
Étienne Fasolt Richard Corvin Meinert1, Rawa Arif1, Matthias Karck1
1Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Insights
This study highlights successful surgical strategies for acute aortic dissection type A, even in complex cases with cerebral malperfusion. Prudent cannulation and repair techniques ensured positive outcomes in a challenging patient scenario.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Disease
Background:
- Acute aortic dissection type A presents significant surgical challenges, especially with cerebral malperfusion and hemodynamic instability.
- Management of supraaortic vessel involvement requires specialized approaches during aortic arch repair.
Abstract:
A 63-year-old man who had acute aortic dissection type A with signs of cerebral malperfusion and hemodynamic instability underwent immediate carotid artery cannulation. A Bentall procedure and total arch repair with frozen elephant trunk implantation were performed with extended cervical access to address supraaortic vessel involvement. We demonstrate that prudent cannulation and repair strategies can be successful even in the most complicated cases of aortic dissection.
