Chef of aortic surgery department Petrovsky National Research Centre of Surgery Moscow, Moskva, Russia
Disclosure(s):
Eduard Charchyan, MD: No financial relationships to disclose
Please explain the educational or technical point that this video addresses.: This video allows you to study the technique of performing a single-stage total aortic replacement in a patient with chronic type B aortic dissection through a thoracoabdominal incision. It is the method of choice in healthy young patients who are not suitable for staged treatment. The technique of protecting the brain and spinal cord, visceral organs, is shown. The technique of surgical access to all segments of the aorta is described.
Please provide a 250 word summary of the surgical video being submitted.: Total aortic replacement (TAR) from valve to bifurcation is a safe approach for younger and fit patients with MAS and provides acceptable midterm outcomes in an experienced center. Thoracoabdominal incision at fourth intercostal space with retroperitoneal approach of abdominal aorta provides satisfactory exposure for the ascending aorta, arch and TAA and minimizes surgical trauma in comparison with another approach for single-stage TAR using bidirectional arterial cannulation with moderate hypothermia is an optimal strategy for cerebral and visceral perfusion that reduces coagulopathy associated with prolonged rewarming and CPB (typically for deep circulatory arrest).
Learning Objectives:
Upon completion, participant will be able to perform surgical approach to all segments of the aorta in case of elective and emergency total aortic replacement
Upon completion, participant will be able to provide protection the brain, spinal cord, and visceral organs using selective perfusion and hypothermia
Upon completion, participant will be able to determine the optimal management for a patient with mega-aortic syndrome, including single-stage treatment
