SummaryTreating complex aortic arch disease with proximal and distal aortic segment involvement is challenging. In recent years, different surgical and endovascular techniques have been applied in a single or multiple-stage approach with the aim to cure and simplify these conditions. The first procedure available for this purpose was the conventional elephant trunk technique. Its recent evolution is the frozen elephant trunk, which treats the descending thoracic aorta using the antegrade release of a self-expandable stent graft. In the following review article, we analyse the advantages and drawbacks of both techniques from clinical and practical perspectives.
Conservative and aggressive root management in acute aortic dissection provided similar results for early and late mortality. Nevertheless, a more extensive root intervention appeared to be protective against aortic reintervention.
Background: Surgical ventricular reshaping (SVR) is a treatment option for patients with severe ischaemic heart failure (HF). Recently, a new minimally invasive, hybrid technique named "less invasive ventricular enhancement" (LIVE), has been developed adopting the Reviven™ Myocardial Anchoring System
Aortic arch surgery was associated with satisfactory early and long-term outcomes. Survival was largely determined by patient comorbidities and postoperative PND. While the underlying aortic disease did not affect long-term mortality, chronic dissection was associated with increased need for aortic reinterventions.
Arch operations after a previous open aortic repair can be performed with acceptable mortality and good long-term outcomes. Complete aortic resection did not increase hospital deaths and was associated with a low need for aortic reinterventions at follow-up.
Although it is more invasive than current endovascular approaches for post-dissection TAAA, open surgical repair can be performed safely with acceptable rates of morbidity and mortality when it is done in a specialized aortic centre. Long-term survival and freedom from aortic reintervention are excellent and should also be taken into account when evaluating less invasive alternatives.
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