title: Open fenestration for complicated acute aortic B dissection.
abstract: Acute type B aortic dissection (ABAD) is a serious cardiovascular emergency in which morbidity and mortality are often related to the presence of complications at clinical presentation. Visceral, renal, and limb ischemia occur in up to 30% of patients with ABAD and are associated with higher in-hospital mortality. The aim of the open fenestration is to resolve the malperfusion by creating a single aortic lumen at the suprarenal or infrarenal level. This surgical procedure is less invasive than total aortic replacement, thus not requiring extracorporeal support and allowing preservation of the intercostal arteries, which results in decreased risk of paraplegia. Surgical aortic fenestration represents an effective and durable option for treating ischemic complications of ABAD, particularly for patients with no aortic dilatation. In the current endovascular era, this open technique serves as an alternative option in case of contraindications or failure of endovascular management of complicated ABAD.
authors.affiliation: 1 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Santi
authors.initials: S
authors.lastname: Trimarchi
authors.affiliation: 1 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Segreti
authors.affiliation: 1 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Viviana
authors.initials: V
authors.lastname: Grassi
authors.affiliation: 1 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lomazzi
authors.affiliation: 1 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Cova
authors.affiliation: 1 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.affiliation: 1 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rampoldi
keywords: Acute type B aortic dissection; malperfusion; open fenestration