Fig. 1

Schematic illustration of performed operative procedures. Patients with acute type A aortic dissection underwent emergency surgery of the aortic valve by either implantation of a biological or mechanical aortic valve prosthesis by the Bentall procedure (A, C) or by aortic valve repair by the David procedure (B, D) as well as implantation of a tube graft. Anastomosis was performed in aortic arch zone 0. In contrast to the control group (A, B), patients of the intervention group (C, D) received additional implantation of a novel non-covered hybrid stent prosthesis (AMDS, ARTIVION, Kennesaw, USA) in the aortic arch and descending thoracic aorta in order to stabilize the true lumen, prevent malperfusion and promote aortic remodeling. The length of the stent in the thoracic aorta varies depending on the size of the implanted prosthesis as well as the individual anatomy of the patient. Therefore, the figure only shows a schematic overview of the surgical techniques