title: Operative results of the anterolateral thoracotomy with partial sternotomy approach for chronic-type B aortic dissection involving the aortic arch.
abstract: There are various treatment strategies for chronic-type B aortic dissection involving the aortic arch. Our aim was to review our surgical experience in the anterolateral thoracotomy with the partial sternotomy approach for chronic-type B aortic dissection involving the aortic arch.
  
  
  
  From January 2000 to October 2015, 39 patients underwent the single-stage open surgery for chronic-type B aortic dissection involving the aortic arch using the anterolateral thoracotomy with partial sternotomy approach.
  
  
  
  Among the 39 patients, 32 were men (82.1%; mean age at surgery, 61.3 ± 11.9 years), with a mean dissecting aortic aneurysm diameter of 50.21 ± 12.20 mm; 28 patients (71.8%) had patent false lumens of the descending aorta. The median interval from dissection occurrence until surgery was 34.05 ± 52.34 months. Twenty-one patients underwent descending aortic replacement plus total aortic arch replacement and 18 underwent descending aortic replacement (plus partial aortic arch replacement). Overall in-hospital mortality and postoperative stroke rates were 5.1% (2 patients) and 10.3% (4 patients), respectively. Survival rates at 1, 3 and 5 years were 94.7%, 94.7% and 90.2%, respectively. Aortic event-free rates at 1, 3 and 5 years were 90.9%, 90.9% and 80.2%, respectively.
  
  
  
  The anterolateral thoracotomy with partial sternotomy approach is a useful surgical procedure with acceptable outcomes for chronic-type B aortic dissection cases involving the aortic arch, when aortic remodelling using thoracic endovascular aortic repair cannot be performed.
authors.affiliation: Department of Cardiovascular Surgery, Hiroshima Shimin Hospital, Nakaku, Hiroshimashi, Hiroshima Prefecture, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Uchino
authors.affiliation: Department of Cardiovascular Surgery, Hiroshima Shimin Hospital, Nakaku, Hiroshimashi, Hiroshima Prefecture, Japan.|Department of Endovascular Treatment for Structural Heart and Aortic Disease, Hiroshima Shimin Hospital, Hiroshima Prefecture, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Yunoki
authors.affiliation: Department of Cardiovascular Surgery, Hiroshima Shimin Hospital, Nakaku, Hiroshimashi, Hiroshima Prefecture, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Sakoda
authors.affiliation: Department of Bioscience and Biotechnology, Graduate School of Agriculture, Shinshu University, Minamiminowa Village, Nagano, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hattori
authors.affiliation: Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Kawabata
authors.affiliation: Department of Cardiovascular Surgery, Hiroshima Shimin Hospital, Nakaku, Hiroshimashi, Hiroshima Prefecture, Japan.|Department of Endovascular Treatment for Structural Heart and Aortic Disease, Hiroshima Shimin Hospital, Hiroshima Prefecture, Japan.
authors.forename: Munehiro
authors.initials: M
authors.lastname: Saiki
authors.affiliation: Department of Respiratory Medicine, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Cardiovascular Surgery, Hiroshima Shimin Hospital, Nakaku, Hiroshimashi, Hiroshima Prefecture, Japan.
authors.forename: Kunikazu
authors.initials: K
authors.lastname: Hisamochi
authors.affiliation: Department of Cardiovascular Surgery, Hiroshima Shimin Hospital, Nakaku, Hiroshimashi, Hiroshima Prefecture, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Cardio Vascular Department, Hiroshima City Hospital, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Oba
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D056346:Sternotomy / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Anterolateral thoracotomy with partial sternotomy; Chronic-type B aortic dissection involving the aortic
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