Abstract:Objective: To analyze the selection of surgical procedures for aortic dissection involving the aortic arch and the efficacy. Methods: The clinical data of patients undergoing surgical treatment due to aortic arch dissection in Department of Cardiothoracic Surgery, Wuhan General Hospital of Guangzhou Command from February 2010 to May 2015 were collected. The selection of surgical procedures and reason for selection as well as the complications were analyzed. Results: A total of 92 eligible patients were recruited after screening. Of the patients, 36 cases underwent thoracic endovascular aortic repair (TEVAR) alone, 2 cases underwent TEVAR with prefenestrated stent graft, 31 cases underwent TEVAR with left subclavian artery coverage, 17 cases underwent non-open chest aortic arch branch bypass plus TEVAR (4 cases of left common carotid artery-left subclavian artery bypass, 3 cases of right common carotid artery-left common carotid artery-left subclavian artery bypass and 10 cases of right common carotid artery-left common carotid artery plus left subclavian artery coverage), and 6 cases underwent open aortic arch replacement. Death occurred in 2 patients after open aortic arch replacement, but on serious complications occurred in the remaining patients. Conclusion: For aortic dissection involving the aortic arch, open aortic arch replacement is a well-developed treatment method. However, TEVAR is a fast, effective and economical method with low complications, and its application can be expanded by combination with other techniques such as fenestration and branch bypss.