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A Simplified Approach to Managing Acute Aortic Dissection: Tips and Tricks

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posted on 2020-12-01, 22:19 authored by Jui-Chuan Tseng, Allison H Fayans, Jonathan M Hemli, Luigi Pirelli, Chad A Kliger, Nirav C Patel, S Jacob Scheinerman, Alan R Hartman, Derek R Brinster

The treatment acute Type I aortic dissection is an essential life-saving operation. This case presentation demonstrates one of the many methods to facilitate reconstruction, with narration offering tips and tricks.

The video depicts the sizing for the antegrade frozen elephant trunk, central aortic cannulation guided by the TEE with the TEE images for reference, moderate hypothermia with ACP/RCP, and root reconstruction with decision-making to utilize Cabrol reconstruction of the coronaries.

References

Hemli JM, Mattia A, Payabyab E, Dudiy Y, Scheinerman SJ, Brinster DR. Aortic cannulation in DeBakey type I aortic dissection facilitates subsequent deployment of a frozen elephant trunk. Heart Lung Circ. 2018 Jun;27(6):767-770.
Payabyab EC, Hemli JM, Mattia A, Kremers A, Vatsia SK, Scheinerman SJ, et al. The use of innominate artery cannulation for antegrade cerebral perfusion in aortic dissection. Journal of cardiothoracic surgery. J Cardiothorac Surg. 15(1):205.
Leshnower BG, Rangaraju S, Allen JW, Stringer AY, Gleason TG, Chen EP. Deep hypothermia with retrograde cerebral perfusion versus moderate hypothermia with antegrade cerebral perfusion for arch surgery. Ann Thorac Surg. 2019 Apr;107(4):1104-1110.