Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia and circulatory arrest

Abstract

Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia and circulatory arrest has low morbidity and mortality. The need for reintervention is low, and long-term survival is excellent. We believe that open repair continues to be the gold standard in patients who are suitable candidates for surgery.

Repair of Thoracic and Thoracoabdominal Mycotic Aneurysms and Infected Aortic Grafts Using Allograft

“…For operations involving the descending or thoracoabdominal aorta with or without arch replacement, our technique has been described elsewhere using deep hypothermia and circulatory arrest [27][28][29] Teflon-felt pledgets, which have high risk for reinfection, were avoided. Self-made CPA tissue pledgets were used if the anastomoses required hemostatic sutures.…”

Commentary Regarding “Outcomes After One Stage Versus Two Stage Open Repair of Type II Thoraco-abdominal Aortic Aneurysms”

“…The authors have not suggested any significant difference resulting from a two staged approach in this large number of patients. In contrast, Corvera et al 3 suggested that open one stage repair of extended TAAA (69 patients with type II TAAA) using deep hypothermia and circulatory arrest has low morbidity, mortality, and re-intervention rates, while posing excellent long-term survival rates.…”

Commentary: Early success of mitochondrial-based biologic therapy for experimental aortic surgery-related spinal cord injury

“…Despite significant advances in the treatment of thoracoabdominal aortic aneurysm (TAA) and other acute aortic syndromes, the risk of ischemic spinal cord injury (SCI) is significant and remains a relatively common and devastating complication after both open surgery and endovascular surgery. 1,2 Years of research have enhanced our understanding of the complex pathophysiology surrounding this problem, including an evolved understanding of the importance of collateral circulation networks. 3 Although there was initial optimism that the transition from open surgery to endovascular approaches (ie, thoracic endovascular aortic repair) would see the end to SCI (or at least a significant reduction), this has not been the case.…”