| Popis: |
Acute dissection of the ascending aorta and aortic arch is a life-threatening disease, and once diagnosed, emergent surgery should be done to achieve satisfactory outcomes. Because of that, surgery has emerged as a classic treatment algorithm. The armamentarium of surgeons includes nowadays a wide spectrum of methods: ranging from conventional open procedures, throughout a full sternotomy, which consists in using extracorporeal circulation with moderate or deep hypothermic circulatory arrest, to total endovascular procedures (thoracic endovascular aortic repair) for antegrade ascending aorta dissection or for retrograde ascending aorta dissection, and last but not the least, to hybrid procedures such as frozen elephant trunk. This chapter has the role to subsequently go from the beginning of its history until the present, but mainly focusing on the new era, a more sophisticated approach, not just for “live to fight another day” philosophy but to entirely prevent chronic complications or to greatly simplify their future management, creating a suitable anatomy for endovascular repair instead of complex redo surgery. |
