Open stented elephant trunk procedure for the repair of complicated type B dissection with an isolated left vertebralartery / 中华胸心血管外科杂志

ABSTRACT

Objeetive To summarize the resuhs of the surgical management of complicated type B dissection with an iso lated left vertebral artery(ILVA) using the stented elephant trunk technique.Methods Between February 2009 and September 2016,12 patients with complicated type B dissection(acute in 7 and chronic in 5) underwent the stented elephant trunk procedure under moderate circulatory arrest with selective antegrade cerebral perfusion.11 patients were males with a mean age of(50.9 ± 6.1) years(ranged 42-59 years).Preoperative limb ischaemia was obscrved in 2 patients,renal dysfunction in 1 patient.Results There was no in-hospital death.1 patient was suffered permanent hoarseness after the surgery.The cardiopulmonary bypass time was 143.1 ± 26.3 min and selective cerebral perfusion time was (27.2 ± 11.2) min.The follow-up time was 6-92 months,mean (40.9 ± 30.6) months.1 of the ischaemia of the limb patients was ameliorated after surgical stentgraft implantation,the other 1 was ameliorated after surgical stent-graft implantation combined with a bypass of the ascending aorta to the right femoral artery.No neurological deficits were observed in any patients prior to hospital discharge.2 patients underwent thoracic endovascular aortic repair and total thoracoabdominal aortic aneurysm repair respectively due to distal aortic aneurysm within the mean follow-up period.Conclusion Surgical repair of complicated type B dissection with an ILVA using the stented elephant trunk technique can obtain a satisfactory med-term clinical results.