Journal of cardiac surgery · 2015
One-Stage Repair of Acute Type B Dissection With Ascending Thoracic Aortic Dilatation Using a Stented Elephant Trunk Procedure.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Li Ming, Qi Rui-Dong, Zhu Jun-Ming, Liu Yong-Min, Zheng Jun, Sun Li-Zhong
Аннотация
BACKGROUND: Acute type B dissection with ascending thoracic aortic dilatation (ATAD) is very common, but remains surgically challenging with the use of the conventional single-stage procedure via median sternotomy or lateral thoracotomy. We report our experience with repair of acute type B dissection with ATAD using a one-stage stented elephant trunk procedure.
METHODS: We retrospectively reviewed the medical records of 16 patients (13 males and 3 females) with acute type B dissection with ATAD who underwent ascending thoracic aortic reconstruction combined with a stented elephant trunk procedure under hypothermic cardiopulmonary bypass with selective antegrade cerebral perfusion between February 2009 and February 2013. ATAD included ascending aortic aneurysm in four patients, ascending aortic enlargement + aortic regurgitation in three, and ascending aortic aneurysm + aortic root aneurysm in nine. Lower limb ischemia occurred in one case.
RESULTS: There was no in-hospital mortality. Drainage of the pericardial sac was indicated for two patients with pericardial effusion. The median durations of ventilator support and intensive care unit stay were 25 ± 18 and 48 ± 7 hours, respectively. Lower limber ischemia was alleviated after implantation of a stented elephant trunk. One patient received thoracoabdominal aortic replacement during follow-up and encountered no postoperative complications.
CONCLUSIONS: Satisfactory surgical results and follow-up outcomes can be achieved using the proposed one-stage stented elephant trunk procedure for acute type B dissection with ATAD.
METHODS: We retrospectively reviewed the medical records of 16 patients (13 males and 3 females) with acute type B dissection with ATAD who underwent ascending thoracic aortic reconstruction combined with a stented elephant trunk procedure under hypothermic cardiopulmonary bypass with selective antegrade cerebral perfusion between February 2009 and February 2013. ATAD included ascending aortic aneurysm in four patients, ascending aortic enlargement + aortic regurgitation in three, and ascending aortic aneurysm + aortic root aneurysm in nine. Lower limb ischemia occurred in one case.
RESULTS: There was no in-hospital mortality. Drainage of the pericardial sac was indicated for two patients with pericardial effusion. The median durations of ventilator support and intensive care unit stay were 25 ± 18 and 48 ± 7 hours, respectively. Lower limber ischemia was alleviated after implantation of a stented elephant trunk. One patient received thoracoabdominal aortic replacement during follow-up and encountered no postoperative complications.
CONCLUSIONS: Satisfactory surgical results and follow-up outcomes can be achieved using the proposed one-stage stented elephant trunk procedure for acute type B dissection with ATAD.