Chronic type A aortic dissection with aortic valve preservation and staged endovascular repair

Chronic Stanford Type A Aortic Dissection (TAAD) is associated with an aortic aneurysm and aortic valve insufficiency more frequently than acute TAAD. Repair options are not well characterized. Here we report the first case of a patient who presented with a chronic TAAD and underwent an aortic valve-sparing aortic root replacement (David procedure) with the replacement of the aorta to the middescending segment, debranching of the supra-aortic vessels, and then staged thoracic endovascular aortic repair. We conclude that the successful management of complex TAAD may require interdisciplinary strategies and expertise, specifically the staged approach to minimize spinal ischemia risk