[Chronic Debakey I aortic dissection in Marfan syndrome and hypertensive patients with modified stented elephant trunk surgery: a post-operative CT assessment].

OBJECTIVE

To assess the outcome of stented elephant trunk surgery for chronic DebakeyIaortic dissection in Marfan syndrome and hypertension patients by CT.

METHODS

Between 2003 and 2008, 54 patients underwent the modified stented elephant trunk procedure and total arch replacement for chronic DebakeyIaortic dissection. Twenty-two patients were made a diagnosis of Marfan syndrome and the other 32 patients of hypertension. Aortic evolvement was evaluated with CT angiography by calculating the diameter ratios between the stent graft/true lumen and the aorta at the same level.

RESULTS

CT study one year after discharge showed no difference in the diameter ratios of the stent and aorta at the carina level between groups (0.84 +/- 0.16 vs 0.80 +/- 0.23, P = 0.472), but had significant difference before and after surgery (0.29 +/- 0.16 vs 0.72 +/- 0.21, P < or = 0.001). And significant difference occurred at the different periods after discharge (0.72 +/- 0.21 vs 0.81 +/- 0.20, 0.81 +/- 0.20 vs 0.77 +/- 0.20, P < or = 0.001). The residual false lumen in the proximal descending aorta reached complete thrombosis in 59% of Marfan and 78% of hypertension.

CONCLUSION

The modified stented elephant trunk technique is effective for closing the false lumen in the proximal descending aorta of chronic DebakeyIaortic dissection in Marfan syndrome and hypertension patients.