Ann Thorac Surg 2007;83:1640
© 2007 The Society of Thoracic Surgeons
Original Articles: Cardiovascular
Invited commentary
Robert Scott Mitchell, MD
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. |
As stated by the authors [1], the role of stent graft technology in the treatment of chronic type B aortic dissections is unclear. In the past decade, thoracic aortic stent grafts have made a major impact on the management of degenerative aneurysms of the descending thoracic aorta. Similarly, stent grafts have greatly facilitated our management of complicated acute type B aortic dissections, especially in regard to malperfusion, in which mortality for central aortic reconstructions approached 60%. Currently under investigation in the INSTEAD trial, the benefit of stent grafts for uncomplicated type B aortic dissections remains unproven.
For chronic type B aortic dissections, the usefulness of thoracic stent grafts remains similarly unclear. Perhaps thoracic stent grafts may be an effective strategy for focal aneurysmal change in a chronic dissection, but significant hazards and limitations abound. Manipulation of a large bore stiff introducer in the aortic arch is not without risk, including creating a new type . . . [Full Text of this Article]
Copyright © 2007 by The Society of Thoracic Surgeons.
