Journal of Southern Medical University ›› 2017, Vol. 37 ›› Issue (01): 102-.

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Brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant
trunk technique for Stanford type A aortic dissection: analysis of 23 cases

  

  • Online:2017-01-20 Published:2017-01-20

Abstract: Objective To assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with
stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection. Methods Twenty-three patients with
Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair
combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3
cases) after the onset of aortic dissection. Results There was no perioperative death in these cases. The mean extracorporeal
circulation time was 209±52 min, the aortic cross clamp time was 85±21 min, and the mean chest tube output within the first 24
h after the operation was 570 ± 263 mL; none of the patients required chest reopening for management of bleeding.
Postoperative acute renal failure requiring hemodialysis occurred in 3 cases, transient neurologic dysfunction in 2 cases,
paraplegia in case and hematosepsis in 1 case. No such complications as permanent neurologic deficit or postoperative visceral
malperfusion occurred in these cases. All the patients survived and were discharged from hospital without experiencing
severe complications in the follow-up for 6-18 months. Conclusion Brachiocephalic artery-sparing aortic arch repair combined
with stent-graft elephant trunk technique is a safe and simple procedure with controllable bleeding and can serve as an
optional procedure for aortic arch replacement.