Repair of acute type A aortic dissections using open replacement with triple-branched stent grafts

Ann Thorac Surg. 2013 Aug;96(2):559-62. doi: 10.1016/j.athoracsur.2013.04.020. Epub 2013 May 24.

Abstract

Background: Total arch replacement to treat type A aortic dissection is a complex procedure. To simplify the procedure, we used a triple-branched stent graft for total aortic arch replacement.

Methods: Between February 2010 and June 2011, 27 patients (mean age, 52.7 ± 11.5 years), with acute type A aortic dissection underwent open surgical placement of a triple-branched stent graft for total arch reconstruction.

Results: All patients were discharged from the hospital. Mean cardiopulmonary bypass time was 160.5 ± 25.2 minutes, aortic cross-clamp time was 85.5 ± 18.4 minutes, and lower body arrest time was 30.2 ± 11.8 minutes. The mean drainage after the operation was 560 ± 120 mL, and the mean blood transfusion was 500 ± 150 mL. The mean length of stay after surgery was 13.5 ± 3.2 days. The mean follow-up time was 19.3 ± 7.6 months (range, 18 to 33 months). Follow-up was 100%. Endoleaks occurred in 3 patients after the operation, and 1 of them died 9 months after the operation. Follow-up computed tomography scans at 3 months showed the elimination of a false lumen in 24 patients.

Conclusions: Using triple-branched stent grafts for total arch reconstruction in acute type A aortic dissections may be an effective technique to eliminate flow in the false lumen.

Keywords: 26.

MeSH terms

  • Adult
  • Aged
  • Aortic Aneurysm, Thoracic / classification
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / classification
  • Aortic Dissection / surgery*
  • Blood Vessel Prosthesis Implantation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Retrospective Studies
  • Stents*