Stepwise external wrapping procedure for Stanford type A aortic dissection in extremely high-risk patients: case reports

Background Acute aortic dissection (AAD) is a rare, but a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A Acute...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2020-06, Vol.15 (1), p.1-138, Article 138
Main Authors: Suematsu, Yoshihiro, Nishi, Satoshi, Arima, Daisuke, Yoshimoto, Akihiro
Format: Article
Language:English
Subjects:
Aneurysms
Aorta
Aortic dissection
Aortic valve
Blood vessels
Care and treatment
Case Report
Case reports
Coronary vessels
Dissection
Health aspects
Heart valves
High-risk patients
Mortality
Patients
Porosity
Pulmonary arteries
Risk
Risk groups
Stepwise external wrapping
Surgery
Type a acute aortic dissection
Veins & arteries
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Summary:Background Acute aortic dissection (AAD) is a rare, but a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A Acute aortic dissection (TAAAD) still remains high, and treatment for such patients remains controversial. Case presentation A new surgical approach which entails "stepwise external wrapping (SEW)" using a zero-porosity artificial graft was developed in extremely high-risk patients with TAAAD. Herein, we described its surgical details and showed two representative cases which was successfully done. Conclusions Our SEW procedure is a feasible alternative to conventional graft replacement for TAAAD in extremely high-risk or aged patients, although the gold standard consists of surgical replacement of the dissected aorta. (129 words). Keywords: Type a acute aortic dissection, Stepwise external wrapping, High-risk patients
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-020-01142-x