STANFORD TYPE-A AORTIC DISSECTION - A NEW SURGICAL APPROACH

We describe a new surgical technique adopted for the repair of Stanfor d type A aortic dissection. In order to minimize the risk of malperfus ion caused by retrograde flow during cardiopulmonary bypass, we avoid femoral artery cannulation. On the hypothesis that it is best not to i nterfere with the hemodynamics of the dissection, we cannulate the dis sected ascending aorta, in either the true or false lumen. We here rep ort 2 cases of successful surgical treatment of Stanford type A aortic dissection. In both cases, the false lumen was cannulated under deep hypothermic circulatory arrest, without clamping the aorta. While the patient was cooling a 10-mm GORE-TEX(R) Side arm was sutured to a Dacr on graft prosthesis. Repair of the aortic arch was carried out 1st. Th e aortic cannula was inserted into the GORE-TEX Side arm, the tubular prosthesis was cross-clamped and cardiopulmonary bypass was reinstitut ed. After this, the aortic bulb was repaired as usual and the tubular prosthesis nas sutured to the bulb. No postoperative cerebral complica tion occurred. Our experience must be confirmed by more cases and a lo nger follow up.