The changing surgical approach to proximal aortic aneurysm disease

Proximal aortic aneurysm can be life threatening in emergency cases when it presents with acute type A aortic dissection or rupture which requires immediate surgical intervention. However, it can be silent and be there for several years. Over the last two decades, there has been dramatic shift from a full sternotomy, elective repair of proximal aortic aneurysm to stenting the aneurysm and minimal invasive techniques to repair such pathologies. Current guidelines indicate urgent operative management for proximal aneurysmal disease when symptomatic, growth rate >0.5 cm per year or size ≥5.5 cm. However, open surgery is associated with high mortality and morbidity rates, and therefore the surgical procedures to proximal aneurysm disease has evolved. Our paper presents current literature on the changing surgical approach to proximal aneurysm disease, which cardiovascular surgeons and physicians must be familiar with for managing these highly complex cases.