الفهرس 
? INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 18 |  |  |
| | | from | 18 | | |
Abstract
With few exceptions, the management of acute type (A) aortic dissection continues to be a prime example of life-saving, emergent open-heart surgery. The operation often involves graft replacement of the dissected ascending aorta, with or without aortic valve repair or replacement. In patients presenting with extensive type (A) aortic dissection, cardiac surgeons have more recently been considering more extensive operations, when possible and appropriate. These may include arch repair, or “arch debranching” with a side-graft bypass to the brachiocephalic and left common carotid arteries to -facilitate subsequent endovascular repair of the more distal dissected thoracic aorta. Treatment approaches for type B aortic dissection are quite different and more varied. Approximately 70% of patients present with uncomplicated dissection. They are best managed medically with anti-impulse and antihypertensive pharmacotherapy especially today, because optimal medical therapy is reportedly yielding an impressively low 30-day mortality rate of 10% or less. On the other hand, patients presenting with complicated dissection are at substantial risk of major sequelae or death and must be considered for surgical or endovascular intervention.