Staged Surgery for Treatment of Three-Channeled Aortic Dissection

Dissection of the wall of an aortic dissection results in a three-channeled aorta. This particular entity creates many problems in the diagnosis and surgical treatment. A 42-year-old male with this lesion underwent successful surgical repair. Fenestration of the abdominal aorta below the renal arteries using a Y-graft was undertaken as the first step, without bypass. This was followed by total replacement of the thoracoabdominal aorta. The patient recovered satisfactorily and remains well. The technique of reconstruction of the splanchnic arteries and the artery to the spinal cord is described.