BACKGROUND: In acute type A dissection, replacing the ascending aorta with the transverse aortic arch recently has been recommended for event-free long-term survival. Since 1994, we have performed our new transverse aortic arch replacement, in which the distal end of the graft is anastomosed between the left common carotid artery and the left subclavian artery to reduce the risk by obtaining a good surgical view, resulting in good hemostasis. The " @entity7105 trunk technique" was used in anticipation of a staged descending aortic operation for residual dissecting aorta. We analyzed the surgical survival of @entity1 with Stanford @entity1580 undergoing our operative procedure using hypothermic selective antegrade cerebral perfusion. METHODS: We performed our new technique in 27 @entity1 (aged 61 +/- 11 years, 15 male and 12 female @entity1 , 22 @entity1 with acute type A dissection, and 5 @entity1 with chronic dissection). RESULTS: One in-hospital @entity204 (3.7% in total: 4.5% in acute dissection, 0% in chronic dissection) occurred in @entity1 undergoing our new technique. Actuarial survival (including early @entity204 ) was 91% at 5 years after the operation. One late @entity204 occurred as the result of a @entity5 . Four @entity1 underwent a staged reoperation for @entity384 of the residual descending aorta or @entity8 as the result of @entity715 from the false lumen 2 to 11 months (mean interval 6 months) after the initial operation. They have been doing well since the reoperation. CONCLUSIONS: Our "distal @entity254 to the proximal level of the distal aortic arch" technique made aortic arch replacement easier and improved the survival of the arch replacement for @entity1580 , especially for acute type A dissection, by securing hemostasis in the suture line. Combining the @entity7105 trunk technique with our new procedure is useful to perform a staged aortic replacement for dilatation and complication of the false lumen in the descending aorta.

Aortic arch repair for Stanford XXXX with distal @entity254 to the proximal level of the distal aortic arch.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal and splenic embolism'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignant tumor'] @entity384 :: ('MESH:D002311', 'Disease') :: ['aneurysmal dilatation'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity7105 :: ('9783', 'Species') :: ['elephant'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombus'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1580 :: ('MESH:C562834', 'Disease') :: ['aortic dissection', 'type A aortic dissection']
@entity1580 :: (MESH:C562834,Disease) :: ['type A aortic dissection']
