Treatment of acute aorta dissection (Type A) using triple-branched stent graft and traditional operation：early outcomes

Li Ming; Zhang Zong-gang; Liu Jun; Guo Yong-zhong; Aibu-lajiang

doi:10.13498/j.cnki.chin.j.ecc.2014.04.13

Abstract：[ Abstract]:Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using triple-branched stent graft and traditional operation. Methods From June 2008 to January 2014, total 39 patients with type A aortic dissec?tion were divided into two groups according to different operation procedure. In A group, 18 patients, including 13 males and 5 females underwent surgical treatment using triple-branched stent graft. In B group, 21 patients, including 16 males and 5 females with the mean age of 45.23±7.10 (35-59) years old, underwent surgical treatment using traditional arch replacement procedure. Results In A group, there were 3 cases (16.7%) of postoperative bleeding and 4 cases (22.2%) of in-hospital deaths. The causes of death included acute renal failure (2 cases), graft infection (1 case) and sternal infection (1 case). During a mean follow-up of 34.26 ±16.12 months, there was no late death. The false lumen thrombosis between the stent graft and the aortic lumen was observed in 12 patients (85.7%, 12/14). While in B group, postoperative bleeding was observed in 2 patients (9.5%), and 2 patients died due to heart failure and 1 died due to severe inferior limb infection. During a mean follow-up of 35.19 ±17.20 months, there was no late death. The false lumen thrombosis between the stent graft and the aortic lumen was 98.7%. Conclusion Under strict indication criteria, it is feasible to perform triple-branched stent graft proce?dure in patients with acute aortic dissection ( type A) , which can simplify operative procedure for the arch. But campared with the fro?zen elephant trunk technique, the rate of false lumen thrombosis is lower using this procedure.