HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Fritz J. Baumgartner Bassam O. Omari Daniel M. Bethencourt Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Baumgartner, F. J. Articles by Bethencourt, D. M. Search for Related Content PubMed PubMed Citation Articles by Baumgartner, F. J. Articles by Bethencourt, D. M.

Ann Thorac Surg 1997;64:1331-1332
© 1997 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Local Transverse Arch Repair for Type A Aortic Dissection

Harbor–UCLA Medical Center, Torrance, and Lakewood Regional Medical Center, Lakewood, California

Accepted for publication May 16, 1997.

Background. The management of retrograde dissections originating from the transverse arch is controversial. Although replacing the ascending aorta is clearly beneficial, the appropriate approach to the management of the arch tear is not as apparent and ranges from no intervention to total arch replacement.

Methods. Three patients presented with acute (n = 2) or subacute (n = 1) aortic dissection, with tears involving the transverse arch. All underwent local transaortic pledgeted suture repair of the arch tears during hypothermic circulatory arrest, as well as graft replacement of the ascending aorta.

Results. Circulatory arrest times ranged from 12 to 15 minutes (transaortic arch repairs alone) to 48 minutes (transaortic arch repair and open distal graft anastomosis). Postoperatively all patients awoke within 12 hours and subsequently did well neurologically.

Conclusions. In the face of a type A dissection with an entry in the transverse arch, local transaortic repair with concomitant ascending aortic replacement represents a viable middle ground between no arch intervention and lengthy arch replacement. Huge entry tears or aneurysmal arch enlargement would preclude such an approach.

This article has been cited by other articles:

				K.-H. Park, K. Sung, K. Kim, T.-G. Jun, Y. T. Lee, and P. W. Park Ascending aorta replacement and local repair of tear site in type a aortic dissection with arch tear Ann. Thorac. Surg., June 1, 2003; 75(6): 1785 - 1790. [Abstract] [Full Text] [PDF]