title: Complex Reoperation for Late Complications After Acute Type A Aortic Dissection Surgery.
abstract: The correct management of acute Type A dissection continues to be a challenge. The primary goal is to save the patient´s life. However, the decision regarding the surgical approach determines possible later complications. We present the case of a 59-year-old female patient with a past history of emergent surgery for acute Type A dissection treated by supracoronary ascending and aortic valve replacement 19 years previously. Later, in a second endovascular approach, the descending aorta was treated by a thoracic endoprosthesis. During follow-up a dilated aortic root and a Type I endoleak were observed, and complex reoperation was required. We performed a total aortic arch replacement with a 4-branched graft and a complete aortic root replacement using the Cabrol technique for the reinsertion of the coronary arteries. The mechanical aortic normally functioning valve was preserved. The patient was discharged 30 days postoperatively.
authors.affiliation: Department of Cardiovascular Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Stöger
authors.affiliation: Department of Cardiovascular Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Matías
authors.initials: M
authors.lastname: Ríos
authors.affiliation: Department of Cardiovascular Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Roberto
authors.initials: R
authors.lastname: Battellini
authors.affiliation: Department of Cardiovascular Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bracco
authors.affiliation: Department of Cardiovascular Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Vadim
authors.initials: V
authors.lastname: Kotowicz
keywords: Aortic root aneurysm; Complication Type A dissection; Reoperation after Type A dissection