Abstract
The debate around surgical technique for the repair of acute type A aortic dissection (ATAAD) has recently centered on whether aortic replacement should extend beyond the ascending aorta. Extended arch techniques involving arch replacement with or without descending aortic stent grafting are being reported in small numbers by select centres. Proposed benefits include resection of primary intimal tears beyond the ascending aorta, resection or exclusion of re-entry tears in the distal aorta, facilitation of re-expansion of the distal true lumen and promotion of false lumen obliteration. A systematic review and meta-analysis was conducted to investigate clinical outcomes of extended arch repair for ATAAD. A novel classification system of heterogeneous surgical techniques is proposed to facilitate discussion and further investigation.
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