Document Detail

Hybrid aortic arch debranching with staged endovascular completion in DeBakey type I aortic dissection.
MedLine Citation:
PMID:  21095323     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We assess midterm results of a hybrid approach to DeBakey type I aortic dissection using a new multibranched Dacron graft to create, by relocation of the inflow openings to the arch vessels toward the aortic root, a new aortic arch for an easier and safer second-staged endovascular stent grafting of the distal thoracic aorta.
METHODS: From March 2006 to July 2008 24 patients with DeBakey type I aortic dissection underwent ascending aorta and aortic arch replacement with debranching of epiaortic vessels using a new prosthesis to create an optimal landing zone for possible subsequent endovascular stent grafting of the distal thoracic aorta. Fifteen patients, who postoperatively presented a residual patent distal false lumen, underwent a successful second-stage endovascular stent-graft implantation.
RESULTS: One patient died after the surgical stage while there was no death after the endovascular stage with hospital mortality of 4.2%. Follow-up confirmed complete thrombosis of the residual distal false lumen in 95.6% and partial thrombosis in 4.4% of patients with no evidence of endoleaks in the cases that required the endovascular procedure. Overall actuarial survival at 28 months is 92.1% ± 7.9% with 100% freedom from reoperation.
CONCLUSIONS: Hybrid treatment of DeBakey type I aortic dissection with aortic arch debranching, using a new multibranched prosthesis (Lupiae Graft; Vascutek Terumo Inc, Scotland, United Kingdom) is confirmed to facilitate the subsequent endovascular completion. Midterm results in terms of survival and distal false lumen thrombosis are satisfactory. Further study of this operation is warranted to confirm the effectiveness and the durability of this approach.
Antonino G M Marullo; Samuele Bichi; Rocco A Pennetta; Gerardo Di Matteo; Antonio M Cricco; Luigi Specchia; Fausto Castriota; Giampiero Esposito
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1847-53     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Cardiovascular Disease, Città di Lecce Hospital, GVM Research and Care, Strada Provinciale per Arnesano, Lecce, Italy.
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MeSH Terms
Aneurysm, Dissecting / mortality,  radiography,  surgery*
Aortic Aneurysm, Thoracic / mortality,  radiography,  surgery*
Blood Vessel Prosthesis*
Dissection / methods*
Endovascular Procedures / methods
Follow-Up Studies
Hospital Mortality
Imaging, Three-Dimensional
Italy / epidemiology
Middle Aged
Prosthesis Design
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Comment In:
Ann Thorac Surg. 2010 Dec;90(6):1853   [PMID:  21095324 ]

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