July 1, 2014Open Access
Best surgical option for arch extension of type B aortic dissection: the open approach.
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Key result
Total arch replacement combined with the frozen elephant trunk technique through sternotomy is a reasonable approach to treat complicated arch extension in acute type B aortic dissection when TEVAR is not feasible.
Population
Patients with acute type B aortic dissection (AD) with arch extension
Design
Review
Authors
Discussion
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Implication
May warrant hybrid arch repair when TEVAR infeasible in acute type B AD; leaves open need for comparative prospective data.
Structured PICO
P
Population
Patients with acute type B aortic dissection (AD) with arch extension
I
Intervention
Surgical arch repair (open approach, frozen elephant trunk, or hybrid arch repair)
For acute type B aortic dissection with arch extension, general management principles for classic type B AD apply, with TEVAR for distal complications and open or hybrid surgical arch repair reserved for complications directly related to the arch pathology.
Limitations
- The safety and efficacy of hybrid procedures in cases with more extensive arch involvement needs to be assessed in further studies.
- Long-term stent-related complications remain an important clinical issue requiring further investigation.
Cite This Study
Kim et al. (2014) conducted a review in Acute type B aortic dissection with arch extension. Open surgical approach (total arch replacement with frozen elephant trunk) vs. Thoracic endovascular aortic repair (TEVAR) or hybrid arch repair was evaluated. Total arch replacement combined with the frozen elephant trunk technique through sternotomy is a reasonable approach to treat complicated arch extension in acute type B aortic dissection when TEVAR is not feasible.
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