Aortic Remodeling After Stepwise External Wrapping for Type A Acute Aortic Dissection

Suematsu, Yoshihiro; Inoue, Takafumi; Nishi, Satoshi; Kurahashi, Kanan; Yoshimoto, Akihiro

doi:10.1016/j.athoracsur.2022.05.070

Cited by 6 publications

(2 citation statements)

References 15 publications

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“…Older and higher-risk patients with larger IMH and/or acute type A aortic dissection with the primary intimal tear in the aortic arch are probably the best candidates for this less-invasive type of repair. As correctly stated by the majority of groups that are not favourable to aortic wrapping, the manipulations around the ascending aorta in the setting of acute dissection are very critical, especially when there is a large haematoma between the aorta and the pulmonary artery [ 5 , 7 ]. In these cases, beating heart cardiopulmonary bypass may be a good option together with a strict control of blood pressure.…”

Section: Commentmentioning

confidence: 99%

“…They reported no hospital mortality and a very low incidence of postoperative complications. The same author reported this technique in 43 patients presenting with acute aortic dissection with 1 hospital death (2.3%) and a low complication rate of 4.6% for neurologic disorder and renal failure [ 5 ]. The follow-up survival rate was 95.3% and 91% at 1 and 3 years.…”

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Aortic wrapping is life-saving in high-risk acute aortic dissection and intramural haematoma

Carrel¹,

Sromicki²,

Schmiady³

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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Aortic wrapping is a controversial repair in patients presenting with acute type A aortic dissection or intramural haematoma but this method may be a potential alternative to medical treatment or conventional repair in patients aged more than 80 years and in those presenting with prohibitive co-morbidities such as stroke, circulatory collapse, full oral anticoagulation with the last generation drugs. We report on 5 high-risk and/or patients over 80 years who received external aortic wrapping with or without cardiopulmonary bypass during the last 18 months. All survived the procedure and could be extubated early postoperatively. No patient remained on the intensive care longer than 2 days and all were discharged without additional complications. Postoperative radiological control was acceptable and no patient had any new aortic event up to 18 months postoperatively. Against the currently accepted strategy, we found external aortic wrapping an interesting alternative method to stabilize the ascending aorta and prevent delayed rupture in the setting of acute aortic dissection and intramural hematoma that would qualify for operative repair. We believe that wrapping should be discussed in patients that would be otherwise denied for conventional aortic repair.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%