Surgical management of aortic dissection with aortic arch involvement

Abstract

The extent of aortic resection for aortic dissection is still debated. Although the resection and replacement of the aortic tract involved by the intimal tear remains the gold standard treatment, the fate and the evolution of the distal false lumen are hardly predictable. In recent years, several techniques and devices have been introduced to reduce the patency of the false lumen with consequent improvement of the positive remodeling of the true lumen, allowing the surgeon to perform a surgical strategy that is the most patient-tailored possible. This chapter aims to discuss hybrid strategies and new devices with related surgical techniques, with a brief literature review, to suggest a management protocol fitting each clinical and anatomical scenario.