Aortic arch stabilization in redo operations for aortic type A dissection.

BACKGROUND

In patients undergoing a new surgical procedure after correction of type A dissection, care must be taken to correct as much as possible the residual lesions and to obliterate, if possible, any residual false lumen.

METHODS

From November 2003 to May 2004, four patients who previously underwent ascending aortic replacement for acute type A aortic dissection underwent a second procedure because of severe aortic root dilatation. The residual false lumen was limited to the arch in two cases, but extended to the whole thoracic aorta in the other two, going down to the abdominal aorta in one of them. A composite valve conduit was inserted, and then a stent was placed in the dissected aortic arch.

RESULTS

All patients had a regular postoperative outcome and were discharged 9-11 days after surgery. The computed tomography angiography scan, performed early and after 6 months, showed no evidence of false lumen in the aortic arch.

CONCLUSIONS

The placement of a stent in the aortic arch in redo cases can be performed with satisfying results because it causes the disappearance of the false lumen. Long-term follow-up is required for the confirmation of these initial positive results.