• J Cardiothorac Surg · Jun 2020

    Case Reports

    Stepwise external wrapping procedure for Stanford type A aortic dissection in extremely high-risk patients: case reports.

    • Yoshihiro Suematsu, Satoshi Nishi, Daisuke Arima, and Akihiro Yoshimoto.
    • Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299 Kaname, Tsukuba, Ibaraki, 300-2622, Japan. suematus@tf7.so-net.ne.jp.
    • J Cardiothorac Surg. 2020 Jun 12; 15 (1): 138.

    BackgroundAcute aortic dissection (AAD) is a rare, but a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A Acute aortic dissection (TAAAD) still remains high, and treatment for such patients remains controversial.Case PresentationA new surgical approach which entails "stepwise external wrapping (SEW)" using a zero-porosity artificial graft was developed in extremely high-risk patients with TAAAD. Herein, we described its surgical details and showed two representative cases which was successfully done.ConclusionsOur SEW procedure is a feasible alternative to conventional graft replacement for TAAAD in extremely high-risk or aged patients, although the gold standard consists of surgical replacement of the dissected aorta. (129 words).

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