Surgical management of distal aortic dissections.

The authors share herein their experience gained in surgical management of 101 patients presenting with distal aortic dissection, describing in detail surgical policy and the technique of reconstructive interventions on the thoracoabdominal and descending thoracic aorta, with both treatment policy and the technique involved having over the past several years changed considerably. Shown herein is efficacy of the so-called "local" prosthetic repair of the descending thoracic aorta as compared to thoracoabdominal prosthetic reconstruction of the aorta, especially if the former variant is combined with directing blood flow to the true aortic lumen. Repeat and stagewise operations were performed in 17 % of cases, with a lethality rate of 28.6 %. The repeat interventions were more often caused by dilatation of the spared segments of the aorta and landing areas with the branches and formation of pseudoaneurysms of aortic anastomoses. Also shown is the initial experience in endovascular treatment of patients with the pathology concerned.