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• W2215671375 abstract "See related article on pages 106–112. Hata et al assessed the midterm outcomes of 2 types of open surgical repair for type B dissecting aortic aneurysm (BDA): left thoracotomy using Dacron graft and median sternotomy under circulatory arrest with stent implantation. Their report covers a 4-year period in which 86 patients with BDA underwent open repair. Their cohort included 4 patients with an “impending rupture,” a term that is vague, subjective, and nondescriptive. For 68 patients in whom the false lumen was patent or the aneurysm extended for “quite a long segment” of the descending or the thoracoabdominal aorta, repair was completed via a left posterolateral thoracotomy (at the third and fifth intercostal spaces) with femoral-femoral cardiopulmonary bypass “with an assist rate of 50%.” For these cases, they performed selective blood perfusion for the celiac axis and both the renal arteries and reconstructed the intercostal arteries at the T12-L1 level, but a cerebrospinal fluid (CSF) drain was not used. The second open repair technique used was open stent implantation via median sternotomy, with circulatory arrest induced at a rectal temperature of 281C and no cerebral perfusion. The procedure was performed in 18 patients in whom the false lumen was thrombosed and the aneurysm was located around the distal arch. The authors stated that they trimmed the proximal side of the graft and then continuously sutured the graft around the orifice of the left subclavian artery. This technique was originally described in 1997 by the Brazilian pioneer surgeon Enio Buffolo and colleagues for the treatment of acute type B aortic dissection by using an endoprosthesis (elephant trunk). In the study by Hata et al, 1.2% of patients (n1⁄4 1) had a stroke and none had temporary neurology dysfunction or paraplegia. The operative mortality rate was 1.2% (1 patient died of a type A acute dissection after undergoing left thoracotomy, the first open" @default.
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• W2215671375 date "2015-01-01" @default.
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• W2215671375 title "It Is Difficult to Compare Apples to Oranges: Acute and Chronic Type B Aortic Dissections, Complicated and Uncomplicated, Are Different and Should Be Treated as Such" @default.
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• W2215671375 doi "https://doi.org/10.1053/j.semtcvs.2015.08.001" @default.
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