Document Detail


Extensive primary repair of the thoracic aorta in acute type a aortic dissection by means of ascending aorta replacement combined with open placement of triple-branched stent graft: early results.
MedLine Citation:
PMID:  20855660     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To simplify extensive primary repair of the thoracic aorta in acute type A aortic dissection, we developed the open triple-branched stent graft placement technique. The early results of this new technique are reported.
METHODS AND RESULTS: Between June 2008 and November 2009, 30 patients with acute Stanford type A aortic dissection underwent extensive primary repair of the thoracic aorta by means of ascending aorta replacement combined with open placement of triple-branched stent graft. Placement of the triple-branched stent graft into the true lumen of the descending aorta, arch, and 3 arch vessels was technically successful in all patients. The mean cardiopulmonary bypass time, aortic cross-clamp time, and lower body arrest time were 151.8 ± 16.69, 84.1 ± 6.97, and 31.17 ± 5.34 minutes, respectively. The postoperative mechanical ventilation support period and duration of intensive care unit stay were 17.93 ± 2.35 and 62.10 ± 9.24 hours, respectively. All implanted stent grafts were fully opened and not kinked; there was no space or blood flow surrounding the triple-branched stent graft and no sidearm graft stenosis or occlusion. The false lumen of the descending aorta distal to the stent graft closed with thrombus in 25 of 30 patients at their first postoperative scans and in 26 of 30 at the 3-month postoperative scan.
CONCLUSIONS: Open triple-branched stent graft placement is an effective technique with satisfactory early results. With this technique, extensive primary repair of the thoracic aorta may become easier and safer for acute type A aortic dissection.
Authors:
Liang-Wan Chen; Xiao-Fu Dai; Lin Lu; Gui-Can Zhang; Hua Cao
Publication Detail:
Type:  Journal Article     Date:  2010-09-20
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2010-10-29     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1373-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China. chenliangwan@tom.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Dissecting / surgery*,  ultrasonography
Aorta, Thoracic / surgery*,  ultrasonography
Aortic Diseases / surgery*
Coronary Artery Bypass / methods
Echocardiography
Equipment Design
Female
Humans
Intensive Care Units
Length of Stay
Male
Marfan Syndrome / complications,  surgery
Middle Aged
Postoperative Period
Stents*
Treatment Outcome
Comments/Corrections
Comment In:
Circulation. 2011 Jun 7;123(22):e619; author reply e620   [PMID:  21646502 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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