General Thoracic and Cardiovascular Surgery

, Volume 67, Issue 1, pp 154–160 | Cite as

How should we manage type B aortic dissections?

  • J. FleerakkersEmail author
  • M. Schepens
SPECIAL EDITION Controversies in Surgery for Thoracic Aorta


Dissection of the descending aorta is a serious and potentially lethal event. Treatment options consist of medical therapy, open surgical replacement of the affected aorta and thoracic endovascular repair. In acute cases, medical treatment is started initially. When complicated, endovascular repair is generally considered as first choice treatment, except for connective tissue disorders where open surgery remains the standard. In stable, uncomplicated patients with risk factors for future aortic growth pre-emptive endovascular repair should be considered in the sub-acute phase of the dissection. The treatment strategy in chronic dissections is somewhat debated. Long-term results and aortic remodeling of endovascular repair are disappointing and open surgery remains the standard.


Type B aortic dissection Endovascular surgery Thoracic aorta Aortic remodeling 


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Copyright information

© The Japanese Association for Thoracic Surgery 2017

Authors and Affiliations

  1. 1.Department of Cardiac SurgeryAZ Sint-JanBruggeBelgium

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