We describe a procedure in which we inserted a modified JOTEC graft following a known complication in the case of a 78-year-old male patient who underwent surgery with the frozen elephant trunk technique for an acute Stanford type A aortic dissection.
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The Management of the Aortic Arch in Type A Aortic Dissection: Replace, Repair with the AMDS, or Leave for Another Day?
J Cardiovasc Dev Dis
January 2025
Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Objectives: Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires emergent surgical intervention. Numerous surgical approaches exist for ATAAD, and controversy remains regarding the optimal arch interventions for ATAAD patients. Aortic Arch Interventions: Approaches to ATAAD repair include hemiarch repair or extended arch repairs, including the hemiarch with a hybrid stent implantation, such as the AMDS hybrid Prosthesis, total arch replacement (TAR), and the use of an elephant trunk and frozen elephant trunk.
View Article and Find Full Text PDFManagement of Non-A Non-B Aortic Dissection: A Narrative Review.
J Cardiovasc Dev Dis
December 2024
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, 79106 Freiburg, Germany.
Non-A non-B aortic dissection remains a complex and controversial topic in cardiovascular management, eliciting varied approaches among cardiologists and surgeons. Due to the limited evidence surrounding this condition, existing guidelines are limited in the complexity of their recommendations. While most patients are initially managed medically, invasive treatment becomes necessary in a large proportion of patients.
View Article and Find Full Text PDFHigh perioperative lactate levels as a potential predictor for severe acute kidney injury following aortic arch surgery.
Front Med (Lausanne)
January 2025
Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
Background: Acute type A aortic dissection (ATAAD) is a life-threatening condition that often requires total aortic arch replacement (TAR) combined with frozen elephant trunk (FET) implantation. Despite advancements in surgical techniques and preoperative management, postoperative acute kidney injury (AKI) remains a prevalent complication that significantly affects patient prognosis, particularly severe AKI. The aim of this study was to investigate the predictive value of perioperative lactate levels in severe postoperative AKI after TAR.
View Article and Find Full Text PDFImpact of mild hypothermic circulatory arrest on surgical outcomes in acute type a aortic dissection patients: a single-centre study.
BMC Cardiovasc Disord
January 2025
Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Background: As hypothermic circulatory arrest (HCA) is being more frequently induced in patients undergoing aortic arch surgery, its safety at different degrees has become a crucial area of study. The aim of this study was to assess the surgical outcomes of mild hypothermic circulatory arrest (MI-HCA) during aortic arch surgery.
Methods: Acute type A aortic dissection (ATAAD) patients who underwent total arch replacement (TAR) and frozen elephant trunk (FET) surgery between January 2014 and December 2023 were enrolled in this study.
Prognostic analysis of acute type A aortic dissection after different surgical interventions: a cohort study.
J Thorac Dis
December 2024
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
Background: Acute type A aortic dissection (ATAAD) requires emergency surgery, but the choice of primary surgery remains controversial. It is believed that simple ascending aorta replacement may lead to higher postoperative survival rate, while the Sun procedure [frozen elephant trunk (FET) + total arch replacement (TAR)] performed in the first stage may obtain better long-term results. The study aimed to compare the outcome of ATAAD patients who underwent the Sun procedure with those without TAR + FET.
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