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One‐Stage Repair of Acute Type B Dissection With Ascending Thoracic Aortic Dilatation Using a Stented Elephant Trunk Procedure
Author(s) -
Li Ming,
Qi RuiDong,
Zhu JunMing,
Liu YongMin,
Zheng Jun,
Sun LiZhong
Publication year - 2015
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12616
Subject(s) - medicine , elephant trunks , aortic dissection , surgery , aortic aneurysm , aneurysm , median sternotomy , thoracotomy , cardiology , aorta
A BSTRACT Background Acute type B dissection with ascending thoracic aortic dilatation (ATAD) is very common, but remains surgically challenging with the use of the conventional single‐stage procedure via median sternotomy or lateral thoracotomy. We report our experience with repair of acute type B dissection with ATAD using a one‐stage stented elephant trunk procedure. Methods We retrospectively reviewed the medical records of 16 patients (13 males and 3 females) with acute type B dissection with ATAD who underwent ascending thoracic aortic reconstruction combined with a stented elephant trunk procedure under hypothermic cardiopulmonary bypass with selective antegrade cerebral perfusion between February 2009 and February 2013. ATAD included ascending aortic aneurysm in four patients, ascending aortic enlargement + aortic regurgitation in three, and ascending aortic aneurysm + aortic root aneurysm in nine. Lower limb ischemia occurred in one case. Results There was no in‐hospital mortality. Drainage of the pericardial sac was indicated for two patients with pericardial effusion. The median durations of ventilator support and intensive care unit stay were 25 ± 18 and 48 ± 7 hours, respectively. Lower limber ischemia was alleviated after implantation of a stented elephant trunk. One patient received thoracoabdominal aortic replacement during follow‐up and encountered no postoperative complications. Conclusions Satisfactory surgical results and follow‐up outcomes can be achieved using the proposed one‐stage stented elephant trunk procedure for acute type B dissection with ATAD. doi: 10.1111/jocs.12616 (J Card Surg 2015;30:756–760)