Mini Access Valve-Sparing Aortic Root and Total Arch Replacement and Stented Graft Implantation in Acute DeBakey Type I Aortic Dissection

  • Cangsong Xiao
  • Yang Wu
  • Weihua Ye

Your browser needs to be JavaScript capable to view this video

Try reloading this page, or reviewing your browser settings

You're watching a preview of subscription content. Log in to check access

This video starts with explanation of preoperative assessment, anesthetic management, and surgical preparation. Key steps of the procedure are precisely illustrated. In a patient with emergent aortic dissection, an emergent valve-sparing procedure combined with total arch replacement and a stent graft implanted is presented with detailed interpretation. The video aims to familiarize the practitioners with the whole process, thereby increasing confidence of surgical success.


There is a significant morbidity and mortality risk on surgical treatment of aneurysms and dissections involving the aortic arch and the descending aorta. For patients with DeBakey type I aortic dissections involving the aortic arch, there has been a focus of debate among cardiovascular surgeons on whether to perform a hemiarch replacement or total arch reconstruction. This video presents a 32-year-old male patient diagnosed with DeBakey type I dissection involving innominate and axillary artery. The surgical plan includes upper hemi-sternotomy and cardiopulmonary bypass set-up, “arch first” reconstruction with a four-branched-graft (Vascutek), aortic root mobilization and sub-annulus suture placement, re-implantation aortic valve-sparing procedure and stented graft implantation into descending aorta and anastomosis. A 28MM four-branched-graft was used for total arch replacement. “Arch first” reconstruction was performed by sequential anastomosis of the three arch vessels with the branched-graft. Post-operative imaging showed a normal aortic root and arch.

About the Authors

Cangsong Xiao

Professor Cangsong Xiao is the chief professor of Department of Cardiac Surgery in Chinese PLA General Hospital, Beijing, China.

Yang Wu

Professor Yang Wu is professor of Department of Cardiac Surgery in Chinese PLA General Hospital, Beijing, China.

Weihua Ye

Professor Weihua Ye is professor of Department of Cardiac Surgery in Chinese PLA General Hospital, Beijing, China.


About this video

Cangsong Xiao
Yang Wu
Weihua Ye
Online ISBN
Total duration
13 min
Springer, Singapore
Copyright information
© Springer Nature Singapore Pte Ltd. 2019

Related content

Video Transcript


This video demonstrates mini access valve-sparing aortic root and total arch placement on beating heart and stented graft implantation through upper hemisternotomy for a patient with acute DeBakey type I dissection and severe aortic insufficiency.

This is a 32-year-old male patient. Preoperative CTA showed DeBakey type I dissection. Innominate and axillary arteries were also involved by dissection. So femoral artery cannulation was performed.

Aortic annulus was parallel to the fourth intercostal space, indicating that aortic root will be well exposed if the sternum was transected at the fourth intercostal space. Pre-operative TTE showed severe aortic valve regurgitation and normal leaflets.