Primary repair of re-entry intimal tear in a patient with limited extension of acute type A aortic dissection

Principles of type A aortic dissection surgery emphasize the importance of operative survival and long-term outcome. Various surgical strategies have emerged aiming for improved freedom of reoperation but they can be technically demanding or associated with higher operative risks. We report a type A aortic dissection case with extension of the dissection to the proximal descending aorta where a re-entry intimal tear was identified. Instead of extensive aortic arch repair, we managed the tear with a primary suture closure technique. In conjunction with a hemiarch repair of the proximal aorta, this approach enabled a prompt and complete resolution of the false lumen at minimal cost of circulatory arrest time.