Non‐A non‐B aortic dissection: A literature review

Howard, Callum; Ponnapalli, Anuradha; Shaikh, Safwan Ahmed; Idhrees, Mohammed; Bashir, Mohammad

doi:10.1111/jocs.15349

Cited by 11 publications

(2 citation statements)

References 56 publications

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“…This approach provides an ideal landing zone for secondary endovascular or open surgical interventions. TEVAR in non-A non-B dissection patients presenting the entry in the aortic arch is unsuitable due to the exceptionally high risk of retrograde aortic dissection of type A [6,[11][12][13].…”

Section: Acute Aortic Dissectionmentioning

confidence: 99%

Thoracic endovascular aortic repair: Current evidence and challenges

Juraszek¹,

Czerny²,

Rylski³

2022

Kardiol Pol

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In 1987 Nikolay Volodos performed the world's first endovascular treatment of aortic aneurysms. Endovascular technology has progressed significantly since then. There are now many thoracic endovascular aortic repair (TEVAR) systems commercially available. By applying them, we can treat many pathologies: aneurysms, dissections, aortic ruptures, and penetrating aortic ulcers. However, TEVAR technology still has its limitations, namely the risk of a retrograde type A dissection, the issue of precise landing in the distal landing zone, and the risk of air embolism and paraplegia. Furthermore, there are no appropriate stent grafts widely available to treat acute dissections. Those currently used are designed for aneurysms, not for dissections. As a result, there are several challenges facing the future TEVAR surgical community, such as the need to develop new and more precise systems with retrograde deployment for the distal landing zone, as well as to introduce flexible stent grafts to treat dissections. The endo-Bentall is being developed as an alternative treatment method for acute type-A aortic dissection.

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Section: Acute Aortic Dissectionmentioning

confidence: 99%

Thoracic endovascular aortic repair: Current evidence and challenges

Juraszek¹,

Czerny²,

Rylski³

2022

Kardiol Pol

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“…Follow‐up was conducted semiannually for the first 3 years, then annually. Six years after index repair, a new aortic dissection involving the distal portion of the aortic arch, left subclavian artery, and extending into the thoracoabdominal aorta was detected (non‐A, non‐B aortic dissection 3 ) on CT angiogram, performed due to the patient presenting acutely with symptoms of back pain. Given the underlying collagen disease and other prognostic factors such as age, patient condition, and previous cardiac surgery, surgery was performed to replace the aortic arch, including a debranching of the supra‐aortic vessels using FET technique in an attempt to close a possible re‐entry in the descending aorta.…”

Section: Case Presentationmentioning

confidence: 99%

Successive surgical repair of a progressive aortic dissection in a case of Loeys–Dietz Syndrome

Pathare

Elbayomi

Tandler

et al. 2022

Journal of Cardiac Surgery

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Introduction The Frozen Elephant Trunk technique is a well‐established treatment for aortic dissections (Stanford Type A) involving the aortic arch and descending aorta. The Thoraflex™ Hybrid prosthesis (Vascutek Ltd.), consisting of a proximal flexible conduit and a distal self‐expanding covered stent, has consistently shown positive results in the treatment of this condition. Case Description The following is a description of such a staged reconstruction using the Thoraflex™ Hybrid Ante‐Flo™ device, performed in a patient previously diagnosed with Loeys–Dietz Syndrome. After clamping the aorta proximally, an incision was taken at the distal end of the stent. Here, the distal end of the new prosthesis was inserted into the true lumen of the descending aorta and the stent was deployed. Following this, a bypass was established via the left atrium, and blood was returned to the lower body using the perfusion arm of the prosthesis with the proximal part of the descending aorta clamped. The collar of the prosthesis was sutured proximally to the aorta near the inlying previous stent. Air was removed via the perfusion arm of the prosthesis, which was then oversewn. Discussion To date, hybrid prostheses have only been used on the proximal aorta in patients with aortic aneurysms and aortic dissections (Stanford Type A). Conclusion Using the described technique, it is possible to reconstruct the aortic anatomy using the available prostheses with accuracy and minimal complications.

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“More or less”: management of type A aortic dissections in the endovascular era

Vasudevan

Sivakumaran

2022

Indian J Thorac Cardiovasc Surg

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Non‐A non‐B aortic dissection: A literature review

Cited by 11 publications

References 56 publications

Thoracic endovascular aortic repair: Current evidence and challenges

Thoracic endovascular aortic repair: Current evidence and challenges

Successive surgical repair of a progressive aortic dissection in a case of Loeys–Dietz Syndrome

“More or less”: management of type A aortic dissections in the endovascular era

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