Surgical techniques in type A aortic dissection surgery

Type A aortic dissection surgery is invariably associated with a high mortality rate. The first challenge that the surgeon faces is to keep the patient alive, regardless of the residual disease in the remaining aorta and the need for re-intervention in the future. Surgical goals are aimed at restoring flow on the true lumen, excluding a main aortic tear and restoring the anatomy and competence for the aortic root and the aortic valve, in order to limit the consequences of visceral and coronary malperfusion, the risk of rupture and tamponade, as well as shock. The clinical context, the available infrastructure and the experience of the surgeon are ultimate determinants for which the most suitable technique should be performed. (C) 2014 Sociedad Espanola de Cirugia TorAcica-Cardiovascular. Published by Elsevier Espana, S.L.U.