Minimally invasive hybrid treatment of acute type I aortic dissection: a single-stage technique without circulatory arrest.
After traditional treatment of acute type I aortic dissection, the possible persistence of residual false lumen in the untouched distal aorta can increase the risk of death.This case report presents an example of single-stage complete hybrid repair of acute type I aortic dissection via surgical interposition of an ascending aortic tube-graft and reconstruction of the supra-aortic branches to enable circulatory inflow from the ascending aortic graft, which was followed by endovascular stenting of the arch and of the descending and thoracic aortic segments. This procedure was performed with partial sternotomy and without circulatory arrest, to improve early and late outcomes.Unfortunately, there is no extensive experience with application of the technique described here, and we are contributing a report of only a single case. Nevertheless, we hope that this description of a single-stage complete repair of aortic dissection might lead to further application and eventually to fewer deaths in patients with acute type I aortic dissection. We suggest this approach for use especially in high-risk patients.
Department of Cardiovascular Surgery, GATA Haydarpasa Education Hospital, 34668 Istanbul, Turkey.
Ahmet Turan
AT
Yilmaz
Sahin
S
Senay
Alper
A
Ucak
D000208:Acute Disease; D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D057510:Endovascular Procedures / Q000295:instrumentation; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome