Thoracic endovascular aortic repair versus open surgery for type-B chronic dissection

The Journal of Thoracic and Cardiovascular Surgery
Eric E Roselli

Abstract

An aging population, increased awareness, high-resolution imaging, and improving access to care all mean that more people are being diagnosed with acute aortic dissection. A better understanding of the role of initial medical therapy, improved surgical techniques, and the addition of endovascular approaches to the treatment algorithm, have resulted in more patients surviving the acute phase of disease. During the chronic phase, patients with residual dissection are challenged by the competing risks of reoperation or death. Open repair for chronic type-B dissection can be performed safely but is a relatively morbid operation. For this reason, surgery is often postponed until patients develop very late complications. Despite encouraging results for thoracic endovascular aortic repair of acute type-B dissection, chronic type-B dissection poses unique challenges that make application of endovascular technology more difficult. As our understanding of the disease and its natural history evolves, the ways in which these 2 methods of treatment complement each other need to be better understood. The benefits and limitations of each therapy, and how and when to apply each in the setting of chronic distal dissection, are discussed.

References

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Citations

Aug 19, 2015·The Journal of Thoracic and Cardiovascular Surgery·Rune Haaverstad, Guttorm L Jenssen
Mar 3, 2015·The Journal of Thoracic and Cardiovascular Surgery·Bradley G Leshnower, Vinod H Thourani
Nov 18, 2017·Annals of Vascular Diseases·Emilia Krol, Jean M Panneton
Dec 19, 2018·Vascular and Endovascular Surgery·Masato FuruiTakeshi Yoshida
Jun 12, 2020·The Annals of Thoracic Surgery·Kyle G MileticEric E Roselli
Nov 28, 2018·The Annals of Thoracic Surgery·Mourad BoufiPeter J Holt
May 14, 2021·Seminars in Thoracic and Cardiovascular Surgery·Gabriel LoorHimanshu Patel
Jul 31, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Anja OsswaldKonstantinos Tsagakis
Oct 28, 2019·Journal of Vascular Surgery·Reuban T D'cruzUNKNOWN Singapore Vascular Surgical Collaborative (SingVaSC)

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