采用三分支支架血管术中置入治疗急性A型主动脉夹层

Department of Cardiothoracic Surgery, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China 

Abstract

Background: Total arch replacement to treat type A aortic dissection is a complex procedure. To simplify the procedure, we used a triple-branched stent graft for total aortic arch replacement. Methods: Between February 2010 and June 2011, 27 patients (mean age, 52.7 ± 11.5 years), with acute type A aortic dissection underwent open surgical placement of a triple-branched stent graft for total arch reconstruction. Results: All patients were discharged from the hospital. Mean cardiopulmonary bypass time was 160.5 ± 25.2 minutes, aortic cross-clamp time was 85.5 ± 18.4 minutes, and lower body arrest time was 30.2 ± 11.8 minutes. The mean drainage after the operation was 560 ± 120 mL, and the mean blood transfusion was 500 ± 150 mL. The mean length of stay after surgery was 13.5 ± 3.2 days. The mean follow-up time was 19.3 ± 7.6 months (range, 18 to 33 months). Follow-up was 100%. Endoleaks occurred in 3 patients after the operation, and 1 of them died 9 months after the operation. Follow-up computed tomography scans at 3 months showed the elimination of a false lumen in 24 patients. Conclusions: Using triple-branched stent grafts for total arch reconstruction in acute type A aortic dissections may be an effective technique to eliminate flow in the false lumen.