Combined Open and Endovascular Repair of Acute Type A Aortic Dissection

Sorokin, Vitaly; Chong, Chee Fui; Lee, Chuen Neng; Wong, Poo Sing; Tan, Lenny; Robless, Peter

doi:10.1016/j.athoracsur.2006.07.057

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…This might increase stroke and paraplegia risk (320,321,322). One certain indication for FET is ATAAD with DescAo rupture (323), and it might also have a particular role in retrograde dissection (324,325), but beyond these, indications are uncertain and controversial (326 -330). Because 5-year re-operation rates are considerably Ͻ15% in most series (211,225,244,250,254,317) and can be performed with modest surgical risk, patient subgroups that definitively derive long-term benefit that might justify perioperative risk need to be identified.…”

Section: Metal Stenting and Separately Deployed Coveredmentioning

confidence: 99%

Evidence, Lack of Evidence, Controversy, and Debate in the Provision and Performance of the Surgery of Acute Type A Aortic Dissection

Bonser

Ranasinghe

Loubani

et al. 2011

Journal of the American College of Cardiology

214

175

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Acute type A aortic dissection is a lethal condition requiring emergency surgery. It has diverse presentations, and the diagnosis can be missed or delayed. Once diagnosed, decisions with regard to initial management, transfer, appropriateness of surgery, timing of operation, and intervention for malperfusion complications are necessary. The goals of surgery are to save life by prevention of pericardial tamponade or intra-pericardial aortic rupture, to resect the primary entry tear, to correct or prevent any malperfusion and aortic valve regurgitation, and if possible to prevent late dissection-related complications in the proximal and downstream aorta. No randomized trials of treatment or techniques have ever been performed, and novel therapies-particularly with regard to extent of surgery-are being devised and implemented, but their role needs to be defined. Overall, except in highly specialized centers, surgical outcomes might be static, and there is abundant room for improvement. By highlighting difficulties and controversies in diagnosis, patient selection, and surgical therapy, our over-arching goal should be to enfranchise more patients for treatment and improve surgical outcomes.

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Section: Metal Stenting and Separately Deployed Coveredmentioning

confidence: 99%

Evidence, Lack of Evidence, Controversy, and Debate in the Provision and Performance of the Surgery of Acute Type A Aortic Dissection

Bonser

Ranasinghe

Loubani

et al. 2011

Journal of the American College of Cardiology

214

175

View full text Add to dashboard Cite

show abstract

“…Open surgery has been used for the treatment of these complex thoracic aortic disease, with a mortality rate of 10% to 20% [2] despite considerable advances in operative techniques and perioperative management. The fatal postoperative complications are often associated with the protracted time of cardiopulmonary bypass and the performance of deep hypothermic circulatory arrest.…”

Section: Discussionmentioning

confidence: 99%

Hybrid procedure for thoracic aortic disease

Sun

Wang

Zhang

et al. 2010

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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Form 2008 to 2009, four patients with complex thoracic aortic disease, including aortic aneurysms and dissections, were successfully treated in our department with a new treatment approach: hybrid procedure. Combined open surgery and endovascular repair were performed in these patients without deep hypothermia or circulatory arrest. Compared to those who underwent traditional open surgery in the same period, time of mechanical ventilation and ICU stay was decreased in these four patients. All of them were discharged soon after operation without postoperative complications or death. The result suggests that this new approach could be an option for thoracic aortic disease, but long-term and large-population studies are still required to demonstrate the safety and validity.

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“…For the type I hybrid arch repair, we used a handmade 4-branch prosthesis (2 aortobifemoral grafts sewn together; Figure 2). 1,2 After completing the proximal anastomosis of the handmade prosthesis with the ascending aorta side-clamp, the other 3 branches were used for triple intrathoracic anatomical debranching. The innominate artery was debranched using end-to-end anastomosis.…”

Section: Case Reportmentioning

confidence: 99%

Coronary and arch hybrid surgery in a patient with infrarenal aortic occlusion

Koh

Ting

Wee

et al. 2018

Asian Cardiovasc Thorac Ann

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A 65-year-old gentleman with claudication underwent contrast-enhanced computed tomography. The scan showed occlusion of the infrarenal abdominal aorta and a 6.0 × 3.7 cm saccular zone-3 arch aneurysm. The left ventricular ejection fraction was 35% and a coronary angiogram revealed triple-vessel disease. In view of the patient's high risk with EuroSCORE II 20.34%, coronary artery surgery was combined with hybrid type I arch aneurysm repair. An endovascular stent was delivered in an antegrade manner. Open heart surgery and a hybrid type I arch intervention can be performed simultaneously through a midline sternotomy approach.

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Combined Open and Endovascular Repair of Acute Type A Aortic Dissection

Cited by 10 publications

References 5 publications

Evidence, Lack of Evidence, Controversy, and Debate in the Provision and Performance of the Surgery of Acute Type A Aortic Dissection

Evidence, Lack of Evidence, Controversy, and Debate in the Provision and Performance of the Surgery of Acute Type A Aortic Dissection

Hybrid procedure for thoracic aortic disease

Coronary and arch hybrid surgery in a patient with infrarenal aortic occlusion

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