Abstract
The surgical options for treating diseases of the aorta have been extended in the past 15 years. In this chapter, established surgical techniques as well as more recent developments in aortic surgery are described in detail. Aortic valve preserving techniques for aortic root replacement and the use of tube grafts with neosinuses, root replacement with complete porcine aortic root grafts, and composite grafts carrying either mechanical or biological valve prostheses are valuable options now for the treatment of aneurysms or dissections of the proximal ascending aorta. The variety of treatment options allow for individualized decision making with regard to patients characteristics, resulting in reduced mortality and morbidity. Aortic arch surgery became safer by introducing new techniques for brain protection, such as antegrade cerebral perfusion techniques either by cannulation of the axillary artery or direct intubation of the supra-aortal branches and combined use of moderate hypothermic circulatory arrest. For distal aortic arch aneurysms, the classic elephant trunk technique is expanded by development of frozen elephant trunk prostheses, assembled from a Dacron prosthesis for arch replacement and a covered stent graft for extension into the descending aorta, a well-suited landing zone for further endoluminal stent graft treatment of the downstream aorta. For open surgical repair of thoracic and thoracoabdominal aneurysms, the currently applied surgical techniques as well as intraoperative perfusion and spinal cord protection strategies are explained.
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References
Aebert H, Laas J, Bednarski P, Koch U, Prokop M, Borst HG (1993) High incidence of aneurysm formation following patch plasty repair of coarctation. Eur J Cardiothorac Surg 7:200–204
Anagnostopoulos CE, Prabhakar MJ, Kittle CF (1972) Aortic dissections and dissecting aneurysms. Am J Cardiol 30:263–273
Aybek T, Sotiriou M, Wöhleke T et al. (2005) Valve opening and closing dynamics after different aortic valve-sparing operations. J Heart Valve Dis 14:114–120
Bachet J, Guilmet D (2002) Brain protection during surgery of the aortic arch. J Card Surg 17:115–124
Bachet J, Guilmet D, Goudot B et al. (1991) Cold cerebroplegia. A new technique of cerebral protection during operations on the transverse aortic arch. J Thorac Cardiovasc Surg 102:85–93
Bachet J, Termignon JL, Goudot B et al. (1996) Aortic root replacement with a composite graft. Factors influencing immediate and long-term results. Eur J Cardiothorac Surg 10:207–213
Bachet J, Goudot B, Dreyfus GD et al. (1999) Surgery for acute type A aortic dissection: the hospital Foch experience. Ann Thorac Surg 67:2006–2009
Bail DH, Walker T, Gruler M, Ziemer G (2007) Preserved Windkessel function in patients following reduction aortoplasty of the ascending aorta. Echocardiography 24:457–463
Baraki H, Hagl C, Khaladj N et al. (2007) The frozen elephant trunk technique for treatment of thoracic aortic aneurysms. Ann Thorac Surg 83:S819–S823
Bavaria JE, Woo YJ, Hall RA, Wahl PM, Acker MA, Gardner TJ (1996) Circulatory management with retrograde cerebral perfusion for acute type A aortic dissection. Circulation 94(9 Suppl):II173–II176
Benedetto U, Melina G, Takkenberg JJ et al. (2011) Surgical management of aortic root disease in Marfan syndrome: a systematic review and meta-analysis. Heart 97:955–958
Bentall H, De Bono A (1968) A technique for complete replacement of the ascending aorta. Thorax 23:338–339
Biglioli P, Roberto M, Cannata A et al. (2004) Upper and lower spinal cord blood supply: the continuity of the anterior spinal artery and the relevance of the lumbar arteries. J Thorac Cardiovasc Surg 127:1188–1192
Borst HG (1981) Replacement of ascending aorta and aortic valve. How to do it. Ann Thorac Surg 32:613
Borst HG, Schaudig A, Rudolph W (1964) Arteriovenous fistula of the aortic arch: repair during deep hypothermia and circulatory arrest. J Thorac Cardiovasc Surg 48:443–447
Borst HG, Walterbusch G, Schaps D (1983) Extensive aortic replacement using “elephant trunk” prosthesis. Thorac Cardiovasc Surg 31:37–40
Cabrol C, Pavie A, Gandjbakhch I et al. (1981) Complete replacement of the ascending aorta with reimplantation of the coronary arteries: new surgical approach. J Thorac Cardiovasc Surg 81:309–315
Cabrol C, Pavie A, Mesnildrey P et al. (1986) Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries. J Thorac Cardiovasc Surg 91:17–25
Carpentier A, Deloche A, Fabiani JN et al. (1981) New surgical approach to aortic dissection: flow reversal and thromboexclusion. J Thorac Cardiovasc Surg 81:659–668
Carrel T, Berdat P, Kipfer B, Eckstein F, Schmidli J (2001) The reversed and bidirectional elephant trunk technique in the treatment of complex aortic aneurysms. J Thorac Cardiovasc Surg 122:587–591
Carrel TP, Berdat P, Englberger L et al. (2003) Aortic root replacement with a new stentless aortic valve xenograft conduit: preliminary hemodynamic and clinical results. J Heart Valve Dis 12:752–757
Chavan A, Lotz J, Oelert F, Galanski M, Haverich A, Karck M (2003) Endoluminal treatment of aortic dissection. Eur Radiol 13:2521–2534
Chuter TA (2007) Fenestrated and branched stent-grafts for thoracoabdominal, pararenal and juxtarenal aortic aneurysm repair. Semin Vasc Surg 20:90–96
Cipriano PR, Griepp RB (1979) Acute retrograde dissection of the descending aorta. Am J Cardiol 43:520–528
Cooley DA, De Bakey ME (1952) Surgical considerations of intrathoracic aneurysms of the aorta and great vessels. Ann Surg 135:660–680
Cooley DA, De Bakey ME (1956) Resection of entire ascending aorta in fusiform aneurysms using cardiac bypass. JAMA 162:1158
Cooley DA, Mahaffey DE, De Bakey ME (1955) Total excision of the aortic arch for aneurysms. Surg Gynecol Obstet 101:667–677
Coselli JS, LeMaire SA (1999) Left heart bypass reduces paraplegia rates after thoracoabdominal aortic aneurysm repair. Ann Thorac Surg 67:1931–1934
Coselli JS, Lemaire SA, Köksoy C, Schmittling ZC, Curling PE (2002) Cerebrospinal fluid drainage reduces paraplegia after thoracoabdominal aortic aneurysm repair: results of a randomized clinical trial. J Vasc Surg 35:631–639
Crawford ES, Saleh CA (1981) Transverse aorta and aneurysm: improved results of treatment employing new modifications of aortic reconstruction and hypo-thermic cerebral circulatory arrest. Ann Thorac Surg 194:180–188
Crawford ES, Saleh SA, Schwessler JS (1979) Treatment of aneurysm of transverse aortic arch. J Thorac Cardiovasc Surg 78:383–393
Crawford ES, Crawford JL, Stowe CL, Safi HJ (1984) Total aortic replacement for chronic dissection occurring in patients with and without Marfan’s syndrome. Ann Surg 199:358–362
Crawford ES, Crawford JL, Safi HJ et al. (1986) Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients. J Vasc Surg 3:389–404
Crawford ES, Coselli JS, Safi HJ (1987) Partial cardiopulmonary bypass, hypothermic circulatory arrest, and posterolateral exposure for thoracic aortic aneurysm operation. J Thorac Cardiovasc Surg 94:824–827
Crawford ES, Coselli JS, Svensson LG, Safi HJ, Hess KR (1990) Diffuse aneurysmal disease (chronic aortic dissection, Marfan, and mega aorta syndromes) and multiple aneurysm. Treatment by subtotal and total aortic replacement emphasizing the elephant trunk operation. Ann Surg 211(5):521–537
Creech O Jr, De Bakey ME, Mahaffey DE (1956) Total resection of the aortic arch. Surgery 40:817–830
David TE, Feindel CM (1992) An aortic valve–sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg 103:617–622
David TE, Armstrong S, Ivanov J, Feindel CM, Omran A, Webb G (2001) Results of valve-sparing operations. J Thorac Cardiovasc Surg 122:39–46
David TE, Feindel CM, Webb GD, Colman JM, Armstrong S, Maganti M (2007) Aortic valve preservation in patients with aortic root aneurysm: results of the reimplantation technique. Ann Thorac Surg 83:S732–S735
David TE, Armstrong S, Manlhiot C, McCrindle BW, Feindel CM (2012) Long-term results of aortic root repair using the reimplantation technique. J Thorac Cardiovasc Surg. doi:10.1016/j.jtcvs.2012.11.075 [Epub ahead of print]
De Bakey ME, Crawford ES, Cooley DA, Morrs GC Jr (1957) Successful resection of fusiform aneurysm of aortic arch with replacement by homograft. Surg Gynecol Obstet 105:657–664
De Bakey ME, Beall AD, Cooley DA et al. (1966) Dissecting aneurysms of the aorta. Surg Clin North Am 46:1045–1055
De Bakey ME, McCollum CH, Crawford ES, Morris GC, Howell H, Noon GP (1982) Dissection and dissecting aneurysms of the aorta: twenty-year follow-up of five hundred twenty-seven patients treated surgically. Surgery 92:1118–1134
De Paulis R, De Matteis GM, Nardi P, Scaffa R, Colella DF, Chiarello L (2000) A new aortic Dacron conduit for surgical treatment of aortic root pathology. Ital Heart J 1:457–463
De Paulis R, De Matteis GM, Nardi P, Scaffa R, Bassano C, Chiariello L (2002) Analysis of valve motion after the reimplantation type of valve-sparing procedure (David I) with a new aortic root conduit. Ann Thorac Surg 74:53–57
De Paulis R, Cetrano E, Moscarelli M et al. (2005) Effects of ascending aorta replacement on aortic root dilatation. Eur J Cardiothorac Surg 27:86–89
DeBois WJ, Girardi LN, Lawrence S et al. (2000) Perfusion method for thoracoabdominal aneurysm repair using the open distal technique. Perfusion 15:231–236
Demers P, Miller DC (2004) Simple modification of “T. David-V” valve-sparing aortic root replacement to create graft pseudosinuses. Ann Thorac Surg 78:1479–1481
Di Eusanio M, Schepens MA, Morshuis WJ, Di Bartolomeo R, Pierangeli A, Dossche KM (2002) Antegrade selective cerebral perfusion during operations on the thoracic aorta: factors influencing survival and neurologic outcome in 413 patients. J Thorac Cardiovasc Surg 124:1080–1086
Egloff L, Rothlin M, Kugelmeier J, Senning A, Turina M (1982) The ascending aortic aneurysms: replacement or repair? Ann Thorac Surg 34:117
Ehrlich MP, Ergin MA, McCullough JN et al. (2001) Favorable outcome after composite valve-graft replacement in patients older than 65 years. Ann Thorac Surg 71:1454–1459
Erbel R, Aboyans V, Boileau C et al. (2014) ESC guidelines on the diagnosis and treatment of aortic diseases. Eur Heart J 35(4):2873–2926
Etz CD, Halstead JC, Spielvogel D et al. (2006) Thoracic and thoracoabdominal aneurysm repair: is reimplantation of spinal cord arteries a waste of time? Ann Thorac Surg 82:1670–1677
Etz CD, Homann TM, Rane N et al. (2007) Aortic root reconstruction with a bioprosthetic valved conduit: a consecutive series of 275 procedures. J Thorac Cardiovasc Surg 133:1455–1463
Fann JI, Smith JA, Miller DC (1995) Surgical management of aortic dissection during a 30-year period. Circulation 92:113–121
Fleck TM, Tschernich H, Grabenwoger M et al. (2003) A double patch sandwich technique for surgical repair of acute aortic dissection type A. Ann Thorac Surg 76:499–502
Frist WH, Baldwin JC, Starnes VA et al. (1986) A reconsideration of cerebral perfusion in aortic arch replacement. Ann Thorac Surg 42:273–281
Fukunaga S, Karck M, Harringer W, Cremer J, Rhein C, Haverich A (1999) The use of gelatin-resorcin-formalin glue in acute aortic dissection type A. Eur J Cardiothorac Surg 15:564–569
Girardi LN, Krieger KH, Mack CA, Lee LY, Tortolani AJ, Isom OW (2005) Does cross-clamping the arch increase the risk of descending thoracic and thoracoabdominal aneurysm repair? Ann Thorac Surg 79:133–137
Gott VL, Gillinov AM, Pyeritz RE et al. (1995) Aortic root replacement. Risk factor analysis of a seventeen-year experience with 270 patients. J Thorac Cardiovasc Surg 109:536–544
Gott VL, Greene PS, Alejo DE et al. (1999) Replacement of the aortic root in patients with Marfan’s syndrome. N Engl J Med 340:1307–1313
Greenberg RK, West K, Pfaff K et al. (2006) Beyond the aortic bifurcation: branched endovascular grafts for thoracoabdominal and aortoiliac aneurysms. J Vasc Surg 43:879–886
Griepp RB, Stinson EB, Hollingsworth JF, Buehler D (1975) Prosthetic replacement of the aortic arch. J Thorac Cardiovasc Surg 70:1051–1063
Hagan PG, Nienaber CA, Isselbacher EM et al. (2000) The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA 283:897–903
Hagl C, Ergin MA, Galla JD et al. (2002) Neurologic outcome after ascending aorta-aortic arch operations: effect of brain protection technique in high-risk patients. J Thorac Cardiovasc Surg 123:581–582
Hagl C, Khaladj N, Karck M et al. (2003) Hypothermic circulatory arrest during thoracic aortic surgery: the theoretical impact of different cerebral perfusion techniques and other methods of cerebral protection. Eur J Cardiothorac Surg 24:358–363
Hammerlijnk R, De Geest R, Brutel de la Reviere A, Defauw J, Knaepen P, Venneulen F (1989) Surgical correction of descending thoracic aneurysms with shunt or bypass techniques versus simple aortic crossclamping. Eur J Cardiothorac Surg 3:37–43
Heberer G, Borst HG, Grill W, Eberlein HJ (1960) Zur Anwendung eines extrakorporalen Umgehungskreislaufs für Operationen an der descendierenden thorakalen Aorta. Langenbecks Arch 296:317–343
Hirazka LF, Bakris GL, Beckmann JA et al. (2010) 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guideline for the diagnosis and management of patients with Thoracic Aortic Disease. Circulation 121:e266–e369
Hiratzka LF, Creager MA, Isselbacher EM et al. (2016) Surgery for aortic dilatation in patients with bicuspid aortic valves. A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practise Guidelines. Circulation 133(7):680–688
Kallenbach K, Karck M, Leyh RG et al. (2002) Valve sparing aortic root reconstruction in patients with significant insufficiency. Ann Thorac Surg 74:S1765–S1768
Kallenbach K, Karck M, Oelze T et al. (2004) Evolving strategies for treatment of acute aortic dissection type A. Circulation 110(Suppl II):II-243–II-249
Kallenbach K, Karck M, Pak D et al. (2005) Decade of aortic valve sparing reimplantation: are we pushing the limits too far? Circulation 112(Suppl I):I-253–I-259
Kallenbach K, Baraki H, Khaladj N et al. (2007) Aortic valve – sparing operation in Marfan syndrome: what do we know after a decade? Ann Thorac Surg 83:S764–S768
Kamiya H, Klima U, Hagl C et al. (2006) Short moderate hypothermic circulatory arrest without any adjunctive cerebral protection for surgical repair of the ascending aorta extending into the proximal aortic arch: is it safe? Heart Surg Forum 9:E759–E761
Kamiya H, Hagl C, Kropivnitskaya I et al. (2007) The safety of moderate hypothermic lower body circulatory arrest with selective cerebral perfusion: a propensity score analysis. J Thorac Cardiovasc Surg 133:501–509
Karck M, Haverich A (2005) Aortic valve reimplantation according to David type I technique. Oper Tech Thorac Cardiovasc Surg 10:246–258
Karck M, Cremer J, Wawersik J, Haverich A (1996) Reoperation for aneurysmal disease of the ascending aorta in patients with concomitant aortic valve incompetence. J Thorac Cardiovasc Surg 112:1392–1393
Karck M, Leyh R, von Kodolitsch Y, Haverich A (2002) Patchwerweiterungsplastik bei Aortenisthmusstenose. Gefahr von lokalen Spätaneurysmen. Dtsch Ärztebl 100:A416–A419
Karck M, Chavan A, Hagl C, Friedrich H, Galanski M, Haverich A (2003) The frozen elephant trunk technique: a new treatment for thoracic aortic aneurysms. J Thorac Cardiovasc Surg 125:1550–1553
Karck M, Kallenbach K, Hagl C et al. (2004) Aortic root surgery in Marfan’s syndrome: comparison of aortic valve sparing reimplantation versus composite grafting. J Thorac Cardiovasc Surg 127:391–398
Karck M, Chavan A, Khaladj N, Friedrich H, Hagl C, Haverich A (2005) The frozen elephant trunk technique for the treatment of extensive thoracic aortic aneurysms: operative results and follow-up. Eur J Cardiothorac Surg 28:286–290
Kawahito K, Adachi H, Murata S, Yamaguchi A, Ino T (2003) Coronary malperfusion due to type A aortic dissection: mechanism and surgical management. Ann Thorac Surg 76:1471–1476
Kay GL, Cooley DA, Livesay JL, Reardon MJ, Duncan JM (1986) Surgical repair of aneurysms involving the distal aortic arch. J Thorac Cardiovasc Surg 91:397–404
Kazui T, Yamashita K, Washiyama N et al. (2007) Aortic arch replacement using selective cerebral perfusion. Ann Thorac Surg 83:S796–S798
Kogel H (2001) Extraanatomische Bypasschirurgie. In: Hepp W, Kogel H (Hrsg.) Gefäßchirurgie. Urban & Fischer, München Jena, S. 475–482
Kotelis D, Geisbüsch P, Attigah N et al. (2011) Total vs hemi-aortic arch transposition for hybrid aortic arch repair. J Vasc Surg 54:1182–1186
Kouchoukos NT, Marshall WG, Wedige-Stecher TA (1986) Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve. J Thorac Cardiovasc Surg 92:691–705
Kouchoukos NT, Masetti P, Rokkas CK, Murphy SF (2002) Hypothermic cardiopulmonary bypass and circulatory arrest for operations on the descending thoracic and thoracoabdominal aorta. Ann Thorac Surg 74:S1885–S1887
Kouchoukos NT, Mauney MC, Masetti P, Castner CF (2007) Optimization of aortic arch replacement with a one-stage approach. Ann Thorac Surg 83:S811–S814
Krüger T, Weigang E, Hoffmann I et al. (2011) Cerebral protection during surgery for acute aortic dissection type A: results of the German registry for Acute Aortic Dissection Type A (GERRADA). Circulation 124:434–443
Krüger T, Conzelmann LO, Bonser RS et al. (2012) Acute aortic dissection type A. Br J Surg 99:1331–1344
Lansman SL, McCullough JN, Nguyen KH et al. (1999) Subtypes of acute aortic dissection. Ann Thorac Surg 67:1975–1978
Lesèche G, Castier Y, Petit MD et al. (2001) Long-term results of cryopreserved arterial allograft reconstruction in infected prosthetic grafts and mycotic aneurysms of the abdominal aorta. J Vasc Surg 34:616–622
Lombardi JV, Carpenter JP, Pochettino A, Sonnad SS, Bavaria JE (2003) Thoracoabdominal aortic aneurysm repair after prior aortic surgery. J Vasc Surg 38:1185–1190
Markewitz A, Weinhold C, Kempkes B, Reicherts B, Hemmer W, Klinner W (1986) Surgical treatment of aneurysms of the ascending aorta: 12 years’ experience in 66 patients. Thorac Cardiovasc Surg 34:287–291
Melissano G, Bertoglio L, Civilini E et al. (2007) Results of thoracic endovascular grafting in different aortic segments. J Endovasc Ther 14:150–157
Miller DC, Stinson EB, Oyer PE et al. (1979) Operative treatment of aortic dissections: experience with 125 patients over a sixteen-year period. J Thorac Cardiovasc Surg 78:365
Minatoya K, Karck M, Hagl C et al. (2002) The impact of spinal angiography on the neurological outcome after surgery on the descending thoracic and thoracoabdominal aorta. Ann Thorac Surg 74:S1870–S1872
Minatoya K, Karck M, Szpakowski E, Harringer W, Haverich A (2003) Ascending aortic cannulation for Stanford type A acute aortic dissection: another option. J Thorac Cardiovasc Surg 125:952–953
Mingke D, Dresler C, Stone CD, Borst HG (1998) Composite graft replacement of the aortic root in 335 patients with aneurysm or dissection. Thorac Cardiovasc Surg 46:12–19
Muller WH Jr, Waren WD, Blanton FG Jr (1960) A method for resection of aortic arch aneurysms. Ann Surg 151:225
Neri E, Toscano T, Papalia U et al. (2001) Proximal aortic dissection with coronary malperfusion: presentation, management, and outcome. J Thorac Cardiovasc Surg 121:552–560
Nienaber CA, Kische S, Ince H (2007) Thoracic aortic stent-graft devices: problems, failure modes, and applicability. Semin Vasc Surg 20:81–89
Ohtsubo S, Itoh T, Takarabe K et al. (2002) Surgical results of hemiarch replacement for acute type A dissection. Ann Thorac Surg 74:S1853–S1856
Orihashi K, Sueda T, Watari M, Okada K, Ishii O, Matsuura Y (2001) Endovascular stent-grafting via the aortic arch for distal aortic arch aneurysm: an alternative to endovascular stent-grafting. Eur J Cardiothorac Surg 20:973–978
Orihashi K, Sueda T, Okada K, Imai K (2004) Near-infrared spectroscopy for monitoring cerebral ischemia during selective cerebral perfusion. Eur J Cardiothorac Surg 26:907–911
Ott DA, Frazier OH, Cooley DA (1978) Resection of the aortic arch using deep hypothermia and temporary circulatory arrest. Circulation 58(Suppl I):227–231
Reuthebuch O, Schurr U, Hellermann J et al. (2004) Advantages of subclavian artery perfusion for repair of acute type A dissection. Eur J Cardiothorac Surg 26:592–598
Robicsek F (1982) A new method to treat fusiform aneurysms of the ascending aorta associated with aortic valve disease: an alternative to radical resection. Ann Thorac Surg 34:92–94
Robicsek F (1985) Compression of the true lumen by retrograde perfusion during repair of aortic dissection. J Cardiovasc Surg 26:36–40
Ross DN (1967) Replacement of the aortic and mitral valves with a pulmonary autograft. Lancet 2:956–959
Sabik JF, Lytle BW, Blackstone EH, McCarthy PM, Loop FD, Cosgrove DM (2000) Long-term effectiveness of operations for ascending aortic dissections. J Thorac Cardiovasc Surg 119:946–962
Safi HJ, Miller CC, Reardon MJ et al. (1998a) Operation for acute and chronic aortic dissection: recent outcome with regard to neurologic deficit and early death. Ann Thorac Surg 66:402–411
Safi HJ, Winnerkvist A, Miller CC et al. (1998b) Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair. Ann Thorac Surg 66:1204–1209
Schäfers H-J, Zeuschner J, Frimpong-Boateng K, Laas J, Schaps D, Haverich A (1987) Aneurysmen der Aorta descendens – Determinanten des operativen Risikos. Z Herz Thorax Gefäßchir 1:177–184
Schepens MA, Vermeulen FE, Morshuis WJ et al. (1999) Impact of left heart bypass on the results of thoracoabdominal aortic aneurysm repair. Ann Thorac Surg 67:1963–1967
Schepens M, Dossche K, Morshuis W et al. (2004) Introduction of adjuncts and their influence on changing results in 402 consecutive thoracoabdominal aortic aneurysm repairs. Eur J Cardiothorac Surg 25:701–707
Schulte HD, Birks W (1971) Zur chirurgischen Behandlung des Aorta ascendens-Aneurysmas mit Aortenklap-peninsuffizienz beim Marfan-Syndrom. Thoraxchir Vask Chir 19:365–372
Schumacher H, Böckler D, Bardenheuer H, Hansmann J, Allenberg JR (2003) Endovascular aortic arch reconstruction with supra-aortic transposition for symptomatic contained rupture and dissection: early experience in 8 high-risk patients. J Endovasc Ther 10:1066–1074
Schumacher H, Von Tengg-Kobligk H, Ostovic M et al. (2006) Hybrid aortic procedures for endoluminal arch replacement in thoracic aneurysms and type B dissections. J Cardiovasc Surg (Torino) 47:509–517
Shiono M, Hata M, Sezai A, Niino T, Yagi S, Negishi N (2006) Validity of a limited ascending and hemiarch replacement for acute type A aortic dissection. Ann Thorac Surg 82:1665–16659
Shrestha M, Baraki H, Maeding I et al. (2012) Long-term results after aortic valve – sparing operation (David I). Eur J Cardiothorac Surg 41:56–61
Shrestha M, Kaufeld T, Beckmann E et al. (2016) Total aortic arch replacement with a novel 4-branched frozen elephant trunk prosthesis: single-center results of the first 100 patients. J Thorac Cardiovasc Surg 152:148–159
Sioris T, David TE, Ivanov J, Armstrong S, Feindel CM (2004) Clinical outcomes after separate and composite replacement of the aortic valve and ascending aorta. J Thorac Cardiovasc Surg 128:260–265
Spielvogel D, Mathur MN, Lansman SL, Griepp RB (2003) Aortic arch reconstruction using a trifurcated graft. Ann Thorac Surg 75:1034–1036
Strauch JT, Spielvogel D, Haldenwang PL et al. (2003) Cerebral physiology and outcome after hypothermic circulatory arrest followed by selective cerebral perfusion. Ann Thorac Surg 76:1972–1981
Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ (1992) Composite valve graft replacement of the proximal aorta: comparison of techniques in 348 patients. Ann Thorac Surg 54:427–437
Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ (1993) Experience with 1509 patients undergoing thoracoabdominal aortic operations. J Vasc Surg 17:357–368
Svensson LG, Labib SB, Eisenhauer AC, Butterly JR (1999) Intimal tear without hematoma. Circulation 99:1331–1336
Thevenet A (1980) L’arrêt circulatoire en hypothermie profonde dans la chirurgie de I’aorte thoracique et ses branches. Ann Chir: Chir Thorac Cardiovasc 34:573–575
Tiwari KK, Murzi M, Bevilacaua S, Glauber M (2010) Which cannulation (ascending aortic cannulation or peripheral arterial cannulation) is better for acute type A aortic dissection surgery? Interact Cardiovasc Thorac Surg 10:797–802
Tsang VT, Cameron DE, Raja SG (2011) How to avoid crimping during valve sparing aortic root replacement using the Valsalva graft. Eur J Cardiothorac Surg 40:266–267
Verdant A, Page A, Cossette R, Dontigny L, Page P, Baillot R (1988) Surgery of the descending thoracic aorta: spinal cord protection with the Gott shunt. Ann Thorac Surg 46:147–154
Vricella LA, Williams JA, Ravekes WJ et al. (2005) Early experience with valve-sparing aortic root replacement in children. Ann Thorac Surg 80:1622–1626
Walker T, Bail DH, Gruler M, Vonthein R, Steger V, Ziemer G (2007) Unsupported reduction ascending aortoplasty: fate of diameter and of Windkessel function. Ann Thorac Surg 83:1047–1053
Wheat MW, Wilson JR, Bartley TD (1964) Successful replacement of the entire ascending aorta and aortic valve. JAMA 188:717–719
Yacoub M, Fagan A, Stassano P et al. (1983) Result of valve conserving operations for aortic regurgitation. Circulation 68:311–321
Yamashita C, Okada M, Ataka K et al. (1998) Reoperation after repair of type A and B dissecting aneurysm. J Cardiovasc Surg (Torino) 39:721–727
Yankah AC, Pasic M, Klose H, Siniawski H, Weng Y, Hetzer R (2005) Homograft reconstruction of the aortic root for endocarditis with perianular abscess: a 17-year study. Eur J Cardiothorac Surg 28:69–75
Yun KL, Miller DC, Fann JI et al. (1997) Composite valve graft versus separate aortic valve and ascending aortic replacement: is there still a role for the separate procedure? Circulation 96(9 Suppl):II-368–II-375
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Karck, M., Kallenbach, K. (2017). Aneurysm and Dissection of the Thoracic and Thoracoabdominal Aorta. In: Ziemer, G., Haverich, A. (eds) Cardiac Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52672-9_27
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