Operation in DeBakey type I acute aortic dissection according to the Florida Sleeve technique

Abstract

Despite the fact that recent decades have witnessed significant advances in treatment of patients with DeBakey type I acute aortic dissection, it still remains difficult to restore the aortic root when the dissection extends to the Valsalva's sinuses. Thinned aortic walls are vulnerable to traumatization on applying a vascular suture. We used in patients with this pathology the Florida sleeve technique in order to reinforce the weakened aortic root. After mobilization of the aortic root and coronary arteries, the transplant 'wraps' the sinuses from the outside, like the neoadventitia, in order to strengthen the weakened aortic wall. The graft's diameter should be selected with due regard for tight enwrapment of coronary sinuses in their maximal dilatation and, if necessary, preserving the possibility of narrowing the fibrous ring. This technique is simple and effective. First, it allows strengthening the weakened root, secondly helping to prevent haemorrhage. Besides, it may prove alternative, should preservation or correction of the geometry of the aortic root be required.