A novel 3 step approach with extensive electrocautery septotomy in the treatment of extensive aortic dissection aneurysms

Classical treatment of acute aortic dissection typ A with replacement of the ascending aorta often in com bination with an open distal anastomosis, does not eliminate all dissected aortic segments. Due to a persistent false lumen perfusion, patients develop post-dissection aneurysms making subsequent aortic reintervention necessary. Treatment of post dissection aortic arch and thoracoabdominal aortic pathologies represent significant therapeutic challenges. True lumen col lapse or take-off of aortic branches from the false lumen may limit endovascular options. Whereas open thoraco-abdominal replacement remains a highest risk surgery. We present herein our initial clinical results of a 3 step approach to treat thoraco abdominal post-dissection aneurysm with electrocautery sep totomy of the dissection membrane.