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. 2018 Apr 4:4:69.
doi: 10.21037/jovs.2018.03.14. eCollection 2018.

Endovascular treatment of acute Type A aortic dissection-the Endo Bentall approach

Maximilian Kreibich  1   2 , Bartosz Rylski  1   2 , Stoyan Kondov  1   2 , Julia Morlock  1   2 , Johannes Scheumann  1   2 , Fabian A Kari  1   2 , Holger Schröfel  1   2 , Matthias Siepe  1   2 , Friedhelm Beyersdorf  1   2 , Martin Czerny  1   2
Affiliations

Endovascular treatment of acute Type A aortic dissection-the Endo Bentall approach

Maximilian Kreibich et al. J Vis Surg. .

Abstract

Outcome after classical surgical repair of acute Type A aortic dissection has steadily improved over the years and several modifications in cannulation and perfusion added to this achievement. However, subgroups remain where results of classical surgical repair still have room for improvement, particularly patients with severe preoperative malperfusion as well as elderly patients with a limited physiological reserve. So far, only small case series or case reports have been published on the endovascular treatment of dissected ascending aortas. However, a tube alone is not sufficient to fix the entire complex underlying problem in the vast majority of patients with acute Type A aortic dissection. In addition, these published reports are either due to a favorable anatomy or due to very localized disease processes, which are the exception and not the rule. The concept of an endovascular valve-carrying conduit may significantly increase the number of patients suitable for endovascular therapy and it may soon be common practice.

Keywords: Type A aortic dissection; ascending thoracic endovascular aortic repair (TEVAR); endovascular valve-carrying conduit.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure S1
Figure S1
The transapical implantation of an endovascular valve-carrying conduit into the ascending aorta of a pig (30). The transcatheter aortic valve and the ascending aortic stent-graft are connected shortly before the implantation with sutures and the two devices can be chosen individually (depending on the aortic annulus size and the ascending aortic length and diameter). The connected device is prepared for transapical access and successfully deployed. Three landing zones are used: the aortic annulus, the sinotubular junction and the distal ascending aorta proximal to the offspring of the brachiocephalic trunk. The uncovered portion between the transcatheter valve and the covered stent graft allows coronary perfusion. Correct deployment was confirmed after animal euthanasia. Available online: http://www.asvide.com/article/view/24017
See this image and copyright information in PMC

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