Trends & Controversies in Type A Aortic surgery in the 21st Century -
Branch first aortic arch replacement
Abstract
Acute Type A aortic dissection (ATAAD) is a condition associated with a
mortality rate up to 26% and significant morbidity. Despite advances in
numerous aspects of cardiac surgery a traditional approach of ascending
aorta and “hemi-arch” replacement utilising deep hypothermic
circulatory arrest (DHCA) and an open distal anastomosis persists for
the management of this condition in most centres. We hereby describe the
rationale behind our surgical approach of the branch-first total aortic
arch replacement technique for the management of ATAAD.