The Prospects for Total Endovascular Repair of Acute Type A Aortic Dissection
Proximal acute aortic dissection [type A] remains a disease with a poor prognosis. High peri-operative open surgical mortality and a significant turn-down rate contribute towards the poor prognosis. Thoracic endovascular stent grafting has revolutionized the treatment of distal [type B] acute aortic dissection. Endovascular therapy may now offer a potential treatment for some patients with type A dissection. Less invasive endovascular therapy, obviates the need for sternotomy and cardiopulmonary bypass, may reduce perioperative morbidity and offers a solution for those patients declined conventional intervention due to co-morbidity or severe complications of the disease. Thoracic stent grafting in the ascending aorta presents specific challenges due to proximity to the aortic valve, navigation over the steep aortic arch and pulsatile aortic movement. The experience of treating Type A dissection with endovascular techniques has evolved slowly but there are now a number of successful case reports in this field.
KeywordsAscending aorta Type A dissection Endovascular repair Endograft