We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Total Arch Replacement with Stented Elephant Trunk Technique: A Proposed Treatment for Complicated Stanford Type B Aortic Dissection.
- Authors
Li, Bin; Sun, Lizhong; Chang, Qian; Zhu, Junming; Yu, Cuntao; Liu, Yongmin; Zheng, Jun; Qi, Ruidong
- Abstract
Objectives: The treatment of Stanford type B aortic dissections involving the arch or associated with proximal aortic aneurysms remains a surgical challenge. We report our results with total arch replacement with the stented elephant trunk (SET) procedure for these complicated Stanford type B aortic dissections. Methods: Between December 2003 and June 2008, 31 patients were admitted for complicated type B dissection (12 acute, 19 chronic). The mean age at operation was 44.3 ± 10.6 years (range: 22-68 years). The surgeries were performed by using total arch replacement combined with SET implantation. Enhanced computed tomography (CT) was performed before discharge as well as 3 months and annually to evaluate the condition of the graft and the residual false lumen. Results: The procedure was successful in all but two patients; two patients died of multiple organ failure following surgery. No paraplegia was observed after surgery. Follow-up was completed in 27 of 29 patients and the mean follow-up period was 18.4 ± 12.3 months (range: 6-54 months). During follow-up CT scans, thrombus formation was observed in the descending aortic false lumen excluded by the stented graft in most patients. One patient died during follow-up while two patients with Marfan syndrome underwent successful operations for replacement of the remaining descending and abdominal aorta. Conclusion: Total arch replacement with the SET procedure has emerged as a viable option for complicated type B dissections and is associated with low morbidity and mortality. At mid-term follow-up, most patients have either thrombosed or have had no further increase in the false lumen of the descending aorta.
- Subjects
AORTIC dissection; TOMOGRAPHY; PARAPLEGIA; MARFAN syndrome; ABDOMINAL aorta surgery; THERAPEUTICS
- Publication
Journal of Cardiac Surgery, 2009, Vol 24, Issue 6, p704
- ISSN
0886-0440
- Publication type
Article
- DOI
10.1111/j.1540-8191.2009.00925.x