The Annals of thoracic surgery
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We performed simultaneous graft replacement of the total aortic arch and ascending aorta for type A aortic dissection with a patent false lumen extending through the arch into the descending or abdominal aorta. During the past 7 years, this procedure was performed in 42 patients (28 men and 14 women), aged 20 to 72 years (mean age, 50 years). Nineteen patients underwent the procedure during the acute period, and 23 during the chronic period. ⋯ There were 3 hospital deaths (7.1%), 1 resulting from acute dissection (5.3%) and 2 from chronic dissection (8.7%). Among the type A dissections, total arch graft replacement has been indicated in the setting of rupture of the aortic arch, arch dissection, and Marfan's syndrome. However, with increasing experience in arch reconstructions and improvement in outcome, the indications could be expanded to include all type A aortic dissections with a patent false lumen in the descending aorta.