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Related Experiment Videos

Local transverse arch repair for type A aortic dissection

F J Baumgartner1, B O Omari, A Pandya

  • 1Harbor-UCLA Medical Center, Torrance 90509, USA.

The Annals of Thoracic Surgery
|December 5, 1997
PubMed
Summary

This study presents a middle-ground approach for managing transverse arch tears in aortic dissection. Local transaortic repair with ascending aorta replacement offers a viable option, avoiding extensive arch surgery.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Aortic Disease
  • Aortic Dissection Management

Background:

  • Management of retrograde dissections from the transverse aortic arch remains controversial.
  • Ascending aorta replacement is beneficial, but arch tear management varies from no intervention to total arch replacement.

Purpose of the Study:

  • To evaluate a less invasive surgical approach for transverse aortic arch tears in aortic dissection.
  • To present a middle-ground strategy between no arch intervention and total arch replacement.

Main Methods:

  • Three patients with transverse aortic arch tears underwent local transaortic pledgeted suture repair.
  • Ascending aorta replacement was performed concurrently with arch repair during hypothermic circulatory arrest.

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Main Results:

  • Patients experienced short circulatory arrest times (12-48 minutes).
  • All patients had favorable neurological outcomes, waking within 12 hours postoperatively.

Conclusions:

  • Local transaortic repair with ascending aorta replacement is a viable option for type A dissection with transverse arch entry.
  • This approach serves as an alternative to extensive arch replacement, though not suitable for huge tears or aneurysmal enlargement.