Acute type B aortic dissection: surgical therapy

Editor's Choice – Management of Descending Thoracic Aorta Diseases

“…115 Neurological complications such as paraplegia (2.3e6.6%), paraparesis (0e3.1%), and stroke (2.7e6.6%) are associated with the extent and duration of the operation. 71,88,115,116 Benefits from extracorporeal circulation in the reduction of neurological complications and renal ischaemia remain controversial. 88,114,115 Other complications include myocardial ischaemia or infarction, respiratory failure, visceral ischaemia, sepsis, multiorgan failure, and limb ischaemia.…”

“…113 Although the results of OR have improved over the last few decades, 114e117 complications remain high, with in hospital mortality rates ranging from 25% to 50%. 70,71,115,116 Preoperative conditions heavily influence outcomes following surgical repair. 71 Patients older than 70 years with hypotension or shock have less favourable outcomes, while those, normotensive at the time of surgery, have better outcomes.…”

Treatment of acute thoracic aortic syndromes using endovascular techniques

“…Moreover, stent placement could be used to prevent retrograde extension of a type-B AD into the proximal aorta. Amongst patients with acute type-B AD, more than half of associated deaths are due to rupture of the false lumen (16). It has been clearly shown that shrinkage of the false lumen is advantageous in acute type-B AD, with the aim of remodeling of the dissected aorta and thrombosis of the false lumen (17).…”

Mid-Term Outcomes of Acute Type B Aortic Dissection in Japan Single Center

“…14,15) In general, open surgery is indicated for the patients with uncontrollable back pain, rapidly expanding false lumen, rupture, or ischemia of main organs when catheter intervention is not feasible. [16][17][18] In our hospital, Open surgery was performed only in patients who had rupture at the time of presentation (3 in the thrombosed group and 9 in the patent group). The surgical procedures were aortic arch replacement in 5 patients, replacement of the descending aorta in 6, and replacement of the thoraco-abdominal aorta in 1.…”