Fate of the distal aorta after surgical repair of acute DeBakey type I aortic dissection: A review Le devenir de l'aorte distale après réparation chirurgicale des dissections aortiques aiguës de type I de DeBakey : une mise au point

Summary Operated acute DeBakey type I aortic dissection has to be considered as a chronicaortic disease with the potential of late distal dilatation with aneurysm formation and need forreoperation. Several intraoperative strategies have been devised to prevent late complications.However, the increased operative risk associated with a more aggressive initial approach in anemergent setting has to be balanced against the relatively low incidence of late reoperations.Further studies will have to identify preoperative risk factors for late distal aortic complicationsmore precisely in order to select patients who might benefit the most from these newer surgicalstrategies.© 2011 Elsevier Masson SAS. All rights reserved. MOTS CLES Aorte ;Dissection ;Procedureschirurgicalescardiaques ;Suivi des patients Resume Le traitement chirurgical des dissections aortique de type I de DeBakey restepalliatif. L’aorte distale reste le plus souvent dissequee en postoperatoire et peut evoluerulterieurement vers une dilatation anevrismale et necessiter une re-intervention. Differentesstrategies chirurgicales ont ete developpees afin de limiter l’incidence de ces complicationstardives. Toutefois, le risque operatoire plus eleve d’une intervention chirurgicale initiale plusagressive doit etre pese par rapport a l’incidence relativement faible des re-interventionstardives. L’identification de facteurs de risques preoperatoires predictifs de complications