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Technical and clinical aspects of surgery for type B aortic dissections 

Technical and clinical aspects of surgery for type B aortic dissections
Chapter:
Technical and clinical aspects of surgery for type B aortic dissections
Author(s):

Ian M. Nordon

DOI:
10.1093/med/9780199658220.003.0061
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date: 18 September 2019

Surgical treatment of type B aortic dissection remains a challenge. Patients requiring intervention may be managed by traditional open surgery or thoracic endovascular repair (TEVAR). TEVAR is far less invasive, and its availability and relative ease of application has changed and extended management options in thoracic aortic disease (TAD), including in those patients deemed unfit or unsuitable for open surgery. The outcome of using either approach depends on meticulous planning and care from a team experienced in TAD management. Patients are exposed to risks of mortality, stroke, paraplegia, and renal failure. In this chapter the techniques of open surgery and TEVAR are described, and the evidence for outcomes is reviewed in association with the current methods of reducing perioperative morbidity. There are no comparative trials exploring which technique is superior; however, TEVAR is being rapidly embraced as the treatment of choice in those patients morphologically suitable, with acute dissection.

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