[Clinical application of stented elephant trunk technique for complicated Stanford type B aortic dissection].

OBJECTIVE

To summarize the experience of the application of stented elephant trunk procedure in the treatment of the patients with complicated Stanford type B aortic Dissection.

METHODS

Between January 2004 and March 2009, 33 patients (27 male and 6 female) underwent stented elephant trunk implantation in the descending aorta for complicated type B dissection. Right auxiliary artery cannulation was routinely used for cardiopulmonary bypass and selected cerebral perfusion. The stented elephant trunk was implanted through the aortic arch under hypothermic circulatory arrest. Complications were recorded to evaluate the immediate and mid-term results.

RESULTS

Cardiopulmonary bypass time was 174 +/- 29 min, and average selective cerebral perfusion and lower body arrest time was 24 +/- 9 min. The in-hospital mortality was 6.0% (2/33). No paraplegia was observed after surgery. During follow-up CT-scans thrombus formation was observed within the descending aortic false lumen excluded by the stented graft in the acute and chronic aortic dissections. There was one death during follow-up.

CONCLUSIONS

The stented elephant trunk procedure could be an effective treatment for complicated type B dissection; it also could close the false lumen of the descending aorta and in preventing expansion of the descending aorta.