Letter From the Guest Editor: Surgical Management of Acute Aortic Dissections: Tricks and Tips to Simplify the Operation

For this CTSNet Guest Editor Series, Surgical Management of Acute Aortic Dissections: Tricks and Tips to Simplify the Operation, we asked Konstadinos A. Plestis, MD, to bring together videos that highlight techniques to effectively treat this lethal disease. 

• A series video will be released each day through December 7. Video titles are listed below this letter from the guest editor.
• On December 10, CTSNet is excited to host Dr Plestis and his contributors for a live discussion on this topic. For more information on this event and to register, click here.

Dear CTSNet Reader,

I appreciate the opportunity to be the guest editor for a series on "Surgical Management of Acute Aortic Dissections: Tricks and Tips to Simplify the Operation." I think this is a very pertinent topic since the majority of patients with acute aortic dissection are treated primarily by non-aortic surgeons, and the mortality rates remain high despite significant progress in the diagnosis of this lethal disease. Most aortic centers advocate a conservative tear-oriented strategy, as the primary objective in this high-risk group of patients. There is no doubt that there are many technical details that play a critical role in the safe execution of these operations and affect outcomes. This series of surgical videos focuses on the technical aspects of these operations that can help cardiac surgeons to address these difficult cases. The videos do not focus primarily on the most difficult cases, or the most extensive operations, but rather on standard techniques that can be replicated by all surgeons.

Key points in each video include:

• Preoperative transthoracic (TTE) or transesophageal (TEE) echocardiogram with emphasis in the aortic valve and ventricular function
• Preoperative CT scan
• Canulation strategy
• Cerebral protection (temperature for instituting hypothermic circulatory arrest, antegrade cerebral perfusion, retrograde cerebral perfusion, no perfusion)
• Myocardial protection strategy
• Handling the aortic root
• Handling the aortic valve
• Handling the distal aorta
• Techniques to prevent bleeding
• Postoperative TEE/TTE
• Postoperative CT scan

A number of very talented cardiothoracic surgeons with expertise in aortic surgery have agreed to present their videos in this series. I hope that the cardiovascular community will find these videos helpful in their everyday practice.

Sincerely,

Konstadinos A. Plestis,

MD Director of Jefferson Aorta Center

CTSNet thanks Ethicon for its generous support of this Guest Editor Series.
For more information, please visit https://www.ethicon.com.

Guest Editor Series Videos:

A Simplified Approach to Managing Acute Aortic Dissection: Tips and Tricks
By Jui-Chuan Tseng, Allison H. Fayans, Jonathan Hemli, Luigi Pirelli, Chad A. Kliger, Nirav Patel, S. Jacob Scheineman, Alan Hartman, Derek Brinster

Zone 2 Aortic Arch Debranching for the Treatment of Type A Aortic Dissection
By Saket Singh, Rachel Chinian, Roland Assi, Prashanth Vallabhajosyula

Type A Aortic Dissection With Hemi Arch Replacement
By Oleg Orlov, Vishal Shah, Konstadinos Plestis

Surgical Management of Type A Aortic Dissection
By Edgar Aranda-Michel, Derek Serna-Gallegos, Ibrahim Sultan

Consistency Is Key: A Reproducible Approach to Managing Acute Type A Aortic Dissection
By John Kelly, Joshua Grimm, Wilson Szeto

Aortic Dissection Repair: Tips and Tricks
By Chris Mehta, Aaron Clark, Chris Malaisrie

Valve Sparing in Type A Aortic Dissection
By Vishal Shah, Oleg Orlov, Konstadinos Plestis