Aortic Arch Replacement in Patients With Chronic Dissection: Special Considerations.

摘要: The progressive expansion of residual, chronic DeBakey type I dissection often necessitates repair the aortic arch and distal aorta (ie, descending thoracic thoracoabdominal aorta). vast majority patients with facing surgery are survivors emergent proximal for acute dissection, thus, these now face a reoperative procedure necessitating redo median sternotomy. One approach repairing incorporates total transverse replacement without an elephant trunk extension; extension is useful strategy, because commonly ectatic or aneurysmal at time repair-using facilitates subsequent in aorta. Patients should participate imaging surveillance protocol.