Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage

Remodeling is a commonly encountered term in the field of cardiothoracic surgery that is often used to describe various pathophysiological changes in the dimension, structure, and function of various cardiac chambers, including the aorta. Stanford type A or DeBakey type 1 aortic dissection (TAAD) is...

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Autor principal:	Kaushalendra Singh Rathore
Formato:	article
Lenguaje:	EN
Publicado:	Korean Society for Thoracic & Cardiovascular Surgery 2021
Materias:	stents dissection intervention rupture Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/270e8970fecf4b3bb64cfc7742c6ab3c
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spelling	oai:doaj.org-article:270e8970fecf4b3bb64cfc7742c6ab3c2021-12-03T01:12:42ZDistal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage10.5090/jcs.21.0272765-16062765-1614https://doaj.org/article/270e8970fecf4b3bb64cfc7742c6ab3c2021-12-01T00:00:00Zhttps://doaj.org/toc/2765-1606https://doaj.org/toc/2765-1614Remodeling is a commonly encountered term in the field of cardiothoracic surgery that is often used to describe various pathophysiological changes in the dimension, structure, and function of various cardiac chambers, including the aorta. Stanford type A or DeBakey type 1 aortic dissection (TAAD) is a perplexing pathologic condition that can present surgical teams with the need to navigate a maze of complex decision-making. Ascending or hemi-arch replacement leaves behind a significant amount of distal diseased aortic tissue, which might have a persistent false lumen or primary or secondary intimal tears (or communications between lumina), which can lead to dilatation of the aortic arch. Unfavorable aortic remodeling is a major cause of distal aortic deterioration after the index surgery. Cardiac surgeons are aware of post-surgical cardiac chamber remodeling, but the concept of distal aortic remodeling is still idealized. The contemporary literature from established aortic centers supports aggressive management of the residual aortic pathology during the index surgery, and with continuing technical advancements, endovascular stenting options are readily available for patients with TAAD or for complicated type B aortic dissection cases. This review discusses the pathophysiology and treatment options for favorable distal aortic remodeling, as well as its impact on mid- to long-term outcomes following TAAD repair.Kaushalendra Singh RathoreKorean Society for Thoracic & Cardiovascular SurgeryarticlestentsdissectioninterventionruptureMedicine (General)R5-920ENJournal of Chest Surgery, Vol 54, Iss 6, Pp 439-448 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	stents dissection intervention rupture Medicine (General) R5-920
spellingShingle	stents dissection intervention rupture Medicine (General) R5-920 Kaushalendra Singh Rathore Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage
description	Remodeling is a commonly encountered term in the field of cardiothoracic surgery that is often used to describe various pathophysiological changes in the dimension, structure, and function of various cardiac chambers, including the aorta. Stanford type A or DeBakey type 1 aortic dissection (TAAD) is a perplexing pathologic condition that can present surgical teams with the need to navigate a maze of complex decision-making. Ascending or hemi-arch replacement leaves behind a significant amount of distal diseased aortic tissue, which might have a persistent false lumen or primary or secondary intimal tears (or communications between lumina), which can lead to dilatation of the aortic arch. Unfavorable aortic remodeling is a major cause of distal aortic deterioration after the index surgery. Cardiac surgeons are aware of post-surgical cardiac chamber remodeling, but the concept of distal aortic remodeling is still idealized. The contemporary literature from established aortic centers supports aggressive management of the residual aortic pathology during the index surgery, and with continuing technical advancements, endovascular stenting options are readily available for patients with TAAD or for complicated type B aortic dissection cases. This review discusses the pathophysiology and treatment options for favorable distal aortic remodeling, as well as its impact on mid- to long-term outcomes following TAAD repair.
format	article
author	Kaushalendra Singh Rathore
author_facet	Kaushalendra Singh Rathore
author_sort	Kaushalendra Singh Rathore
title	Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage
title_short	Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage
title_full	Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage
title_fullStr	Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage
title_full_unstemmed	Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage
title_sort	distal aortic remodeling after type a dissection repair: an ongoing mirage
publisher	Korean Society for Thoracic & Cardiovascular Surgery
publishDate	2021
url	https://doaj.org/article/270e8970fecf4b3bb64cfc7742c6ab3c
work_keys_str_mv	AT kaushalendrasinghrathore distalaorticremodelingaftertypeadissectionrepairanongoingmirage
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Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage

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