Cabrol Procedure in Complex Aortic Root Reconstruction: A Case Series of Three Young Patients With Acute Aortic Syndrome

Acute aortic dissection is a rare but life-threatening syndrome, being accompanied by a mortality rate of 1%-2% per hour after the onset of symptoms if they remain untreated. The definitive therapy for type A acute aortic dissection is considered to be emergency surgery. However, the optimal method for aortic root reconstruction has been a controversial issue. This study presents three cases of acute thoracic aortic dissection (TAD) accompanied by complicated aortic root anatomy. These critical conditions were managed successfully with the Cabrol procedure. In this procedure, the coronary ostia are anastomosed to a second graft in an end-to-end fashion, which is then connected side to side with the ascending aorta. A 2-year follow-up of patients showed they had no new signs or symptoms or reemergence of them during this period. Follow-up transthoracic echocardiography (TTE) and computed tomography angiography (CTA) of the aorta showed no evidence of obstruction or complications of Cabrol and aortocoronary anastomosis. Although the modified Bentall procedure using coronary ostial aortic "buttons" may produce superior results and currently represents the standard of care for aortic root reconstruction, the Cabrol procedure can be considered a clinically valuable rescue procedure in patients whose management becomes more complicated due to anatomic difficulties.