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Original Articles: Adult Cardiac

Invited Commentary

Department of Cardiothoracic Surgery, Stanford University Medical Center, Falk CVRC, 300 Pasteur Dr, Stanford, CA 94305

(Email: rsmitch@stanford.edu).

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

The combination of aortic arch involvement with a chronic type B aortic dissection is a relatively common scenario whose treatment remains somewhat problematic. Management of the aortic arch or more proximal lesions may be difficult from a thoracotomy exposure, and treatment of the dilated proximal descending thoracic aorta by performing a sternotomy can also be challenging. Combined incisions (thoracosternotomy or bilateral anterior thoracotomy) are associated with increased morbidity. Arch debranching with stent grafting seems to require a similar arch exposure . . . [Full Text of this Article]

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