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Ann Thorac Surg 2005;80:1087-1090
© 2005 The Society of Thoracic Surgeons

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New technology

Combined Surgical and Endovascular Treatment of Aortic Type A Dissection

Clinic for Cardiovascular Surgery, Department of Surgery, University Hospital of Geneva, Geneva, Switzerland

Accepted for publication September 24, 2004.

^_* Address reprint requests to Dr Panos, Clinic for Cardiovascular Surgery, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland (Email: aristotepanos{at}yahoo.com).

PURPOSE: We describe a combined approach for treatment of a type A aortic dissection with surgical repair of the ascending aorta and transluminal stenting of the descending aorta, therefore minimizing the consequences on the untreated aortic arch and descending aorta.

DESCRIPTION: From December 2002 to June 2003, 5 consecutive patients (4 men, 1 woman) suffering from type A aortic dissection were treated with resection of the ascending aorta or aortic hemi-arch. Before the open distal aortic anastomosis the Endofit endovascular graft (Endomed Inc, Phoenix, AZ), was deployed under direct vision distally to the origin of the left subclavian artery.

EVALUATION: Intraoperative stent graft placement was successful in all patients. There was no hospital mortality. Early results were satisfactory with a completely thrombosed false lumen in 2 patients and a partially thrombosed false lumen in 3 patients, 10 days after operation. Follow-up computed tomographic scan showed a completely thrombosed false lumen in 4 patients and a partially thrombosed false lumen in 1 patient.

CONCLUSIONS: This study shows that combined surgical and endovascular treatment of acute type A dissection is a feasible option, but further evaluation is necessary.

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				E. Buffolo Invited commentary Ann. Thorac. Surg., September 1, 2005; 80(3): 1090 - 1090. [Full Text] [PDF]