Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
Abstract:
Surgery for acute aortic dissection is challenging, especially in cases of cerebral malperfusion. Should we perform only the aortic repair, or should we also reconstruct the arch vessels when they are severely affected by the disease process? Here we present a case of acute aortic dissection with multiple tears that involved the brachiocephalic artery and caused cerebral and right upper-extremity malperfusion. The patient successfully underwent complete replacement of the brachiocephalic artery and the aortic arch during deep hypothermic circulatory arrest, with antegrade cerebral protection. We have found this technique to be safe and reproducible for use in this group of patients.