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J Thorac Cardiovasc Surg 2004;127:1821-1823
© 2004 The American Association for Thoracic Surgery

Brief communication

New technologies for the treatment of type A aortic dissection: A case report

^a Cardiac Surgery Department, University of Parma, Parma, Italy
^b Radiology Department, University of Parma, Parma, Italy

Received for publication November 24, 2003; revisions received December 31, 2003; accepted for publication January 13, 2004.

^* Address for reprints: Francesco Nicolini, MD, Cattedra e Divisione di Cardiochirurgia, Università degli Studi, Via A. Gramsci 14, 43100 Parma, Italy
francesconicolini@libero.it

The first 20% of the full text of this article appears below.

Aortic arch replacement in the treatment of type A aortic dissection is justified in emergency settings to prevent later complications,¹ even if it is technically demanding and affected by mortality and morbidity.^2,3 Evolution of residual false lumen remains unpredictable, requiring further high-risk surgical procedures. We report a case of type A aortic dissection treated with ascending aortic replacement associated with a new stent graft positioned in the aortic arch and completed with thoracic endovascular stent graft placement.

Clinical summary

A 78-year-old woman was admitted for acute type A aortic dissection. Preoperative transesophageal echocardiography showed a primary tear located above the aortic cusps and extending to the descending thoracic aorta. Cardiopulmonary bypass was established between the right subclavian artery and the right atrium. At mild hypothermia, the ascending aorta was crossclamped, and cold blood cardioplegia was administered through the coronary ostia. The proximal aortic stump was reconstructed with continuous mattress sutures and Teflon collars after gelatin-resorcin-formol glue application to the false channel. At a nasopharyngeal temperature of 24°C, general circulation was arrested, and cerebral . . . [Full Text of this Article]

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