Surgical management of acute ascending aortic dissection. Progress over forty years.

In 1971, after careful analysis of their own and publishedexperiences of surgical management of acute dissection of theascending aorta, Professor Jean-Paul Cachera and his group havedescribed several technical refinements expected to improve patientoutcome. These refinements included : 1) multiple peripheralarterial cannulations, 2) double cuffing with Teflon of the twolayers of the dissecting process at the anastomotic sites, 3)conservative treatment of the native aortic valve by remodelling ofthe aortic root. The objective of the present review is to accuratelyplace these innovations in the context of forty years of surgery foracute ascending aortic dissection.