Clinical application of modified "elephant trunk" stent-graft in treatment of type Stanford A aortic dissection / 第二军医大学学报

ABSTRACT

Objective: To investigate the procedures and outcomes of modified "elephant trunk" stent-graft technique in the treatment of aortic dissection. Methods: Twenty patients (aged 23-71 years, mean 50.7 years) suffered from type Standford A aortic dissection (acute 14, chronic 6) were included in our study. During deep hypothermic circulatory arrest(DHCA), retrograde cerebral perfusion(RCP) or selected antegrade cerebral perfusion(SCP) was used to protect the brain. All patients received modified "elephant trunk" stent-graft(ascending aorta and semi-arch replacement combined with transluminal stent-graft of the descending aorta). Concomitant operations included 11 Bentall's procedures and 2 Cabrol's procedures. Circulatory arrest time ranged from 36 to 86 min (mean 34.5 min). Results: Two patients died after operation (10%). Survival patients were followed up for 3 to 24 months and no subsequent death occurred during the fellow-up period. Multi-detector row computed tomography angiography of aorta was performed in 10 patients 3 months after surgery. Complete thrombosis of the false lumen in descending aorta was found in 8 cases and partial thrombosis was found in 2 cases. Conclusion: Our modified "elephant trunk" stent-graft is a simple method with short circulatory arrest time. It has a similar outcome as standard "elephant trunk" stent-graft. The long-time false lumen occlusion rate of descending aorta demands further clinical follow-up investigation.