Antero-Lateral Thoracotomy with Partial Sternotomy for Retrograde DeBakey III Type Closing Aortic Dissection

(Department of Cardiovascular Surgery, Chugoku Rosai Hospital, Cerebro-Cardiovascular Center, Kure, Japan)

Masafumi Sueshiro Saiho Hayashi Hironori Kobayashi
We report 2 cases of retrograde DeBakey III type (Stanford A type) closing aortic dissection in a state of shock. At the preoperative assessment, we could not confirm the region of entry in either of them. Consequently, to close the entry, we decided to perform antero-lateral thoracotomy with partial sternotomy (ALPS) and good results were obtained. This method has 3 advantages. 1) The wide field of view enables visualization from the ascending to the descending aorta. 2) Because of the good field of view, we are able to suture without difficulty and minimize the volume of bleeding. 3) We can minimize influence on the lung because the upper sternum is not incised, thus we can handle the lung gently while performing the planned incision.
@Jpn. J. Cardiovasc. Surg. 35: 21-24 (2006)