Aortic valve resuspension using the Florida sleeve technique with replacement of the aortic arch by stent grafting the thoracic aorta with the hybrid prosthesis E-Vita Open Plus in a patient with DeBakey type I acute aortic dissection.

Abstract

Surgery for acute type A aortic dissection is highly challenging, even in expert hands. The goal in such emergency circumstances is primarily to save the patient's life. To minimize the perioperative risk, surgeons often choose surgery involving only supracoronary ascending aortic and hemiarch replacement. However, to achieve a successful repair, the extremely fragile dissected aortic layers must be reconstructed proximally and distally. Most of the surgical procedures for patients with acute type A aortic dissection are supracoronary ascending aortic replacements. Thereby, the Florida sleeve procedure is an attractive alternative for reimplanting the entire aortic root into a Dacron graft. This approach has overcome most of the technical problems associated with composite valve graft or valve-sparing procedures. The frozen elephant trunk procedure is particularly appealing for treating acute type A aortic dissection because of its ability to treat malperfusion by encouraging true lumen expansion and potentially reducing longer-term adverse remodelling within the descending aorta.