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Vessel Plus 2021;5:[Accepted].10.20517/2574-1209.2021.88@The Author(s) 2021
Accepted Manuscript
Open AccessPerspective

Open repair for thoracoabdominal aortic aneurysms precipitated by chronic aortic dissection


Correspondence Address: Dr. Joseph S. Coselli, Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, One Baylor Plaza, BCM 390, Houston, TX 77030, USA. E-mail: jcoselli@bcm.edu

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© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Abstract

Chronic dissection of the thoracoabdominal aorta may require surgical repair for aneurysm, malperfusion, or rupture. Endovascular repair is made difficult by a noncompliant dissection septum, visceral vessels arising from different lumens, and the common use of diseased aortic landing zones. Thus, open repair remains the gold standard in terms of favorable outcomes and durability. During thoracoabdominal aortic repair, we use a multimodal strategy to prevent spinal cord and visceral or renal artery ischemia; key modalities include cerebrospinal fluid drainage, left heart bypass with and without visceral protection, cold renal protection, and aggressive reimplantation of intercostal or lumbar arteries. Patients with chronic dissection require lifelong surveillance, as there is a significant risk for subsequent intervention on unrepaired aortic segments.

Cite This Article

Hong JC, Coselli JS. Open repair for thoracoabdominal aortic aneurysms precipitated by chronic aortic dissection. Vessel Plus 2021;5:[Accept]. http://dx.doi.org/10.20517/2574-1209.2021.88

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