Extended arch resection in acute type A aortic dissection: CON.
Acute type A dissection is one of the most lethal conditions that surgeons encounter. Advances in surgical techniques and perioperative management have resulted in acceptable short- and long-term outcomes. Traditionally, the surgical approach involves a conservative extent of aortic arch resection. Recently, some groups have advocated a more aggressive approach wherein the entire aortic arch is replaced or an adjuvant descending aortic stent graft placed. This article reviews the literature pertaining to extent of distal aortic replacement in acute type A aortic dissection, arguing that a conservative approach is associated with more favorable outcome.
Geirsson
Arnar
A
Section of Cardiac Surgery, Yale University School of Medicine, 333 Cedar Street, Boardman 204, PO Box 208039, New Haven, CT 06520-8039, USA. arnar.geirsson@yale.edu
D000208:Acute Disease; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D006801:Humans; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*