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Page 14 of 17 Hong et al. Vessel Plus 2022;6:4 https://dx.doi.org/10.20517/2574-1209.2021.88

Figure 12. The completed repair of a DeBakey type III aortic dissection. A four-branched graft was used to aid Crawford extent II
thoracoabdominal aortic aneurysm repair. Alternates to this approach include a single visceral patch that incorporates the celiac axis,
superior mesenteric artery, and both renal arteries (upper inset) or a three-vessel patch that incorporates the celiac axis, superior
mesenteric artery, and right renal arteries, with the left renal artery reattached as a button (lower inset). The figure is used with the
permission of Baylor College of Medicine.

maximize oxygen delivery to end organs. The CSF drain is typically kept in place for 48-72 h
postoperatively. The CSF drain is usually clamped for 8-12 h before removal to test for latent development
of spinal ischemia. We typically extubate patients within 24 h and slowly start them on a solid diet on
postoperative day 4. Typically, patients are discharged 7-10 days after open repair. Higher MAP goals are
maintained for 4-6 weeks after surgery to prevent late neurological complications.

CONCLUSION
Chronic aortic dissections of the thoracoabdominal aorta are vulnerable to aneurysmal degeneration,
rupture, malperfusion, or symptoms related to compression of surrounding structures related to aortic
expansion. In studies of open repair of TAAAs precipitated by chronic dissection, the early mortality rate is
6%-8%; the stroke rate is 1%-4%; the incidence of paraplegia is 1%-3%, and the incidence of renal failure
[37]
requiring dialysis is 4%-5% [19,34-41] . However, open repair has favorable long-term durability. Estrera et al.