“Branch-First total arch replacement”: a valuable alternative to frozen elephant trunk in acute type A aortic dissection?
Indian Journal of Thoracic and Cardiovascular Surgery(2021)
Abstract
The “Branch-First total arch replacement” technique has been used extensively in both elective and acute situations, including in type A aortic dissection. The focus of the Branch-First technique is to reduce the risk of neurological and end-organ dysfunction associated with arch replacement by optimising neuroprotection, distal organ perfusion and myocardial protection. The Branch-First technique is a valuable alternative to the frozen elephant trunk (FET) technique in type A aortic dissection, providing a stable landing zone for subsequent interventions on the distal aorta should they be required. Combining the Branch-First technique with FET in appropriate cases can further improve outcomes. We discuss the merits of the Branch-First technique, and contrast them to those of FET techniques for repair of type A aortic dissection.
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Key words
Total aortic arch repair,Aortic arch replacement,Antegrade cerebral perfusion,Branch-First,Frozen elephant trunk,Acute aortic dissection
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