OBJECTIVETo evaluate the therapeutic effect and safety of thoracic aortic replacement with concomitant endoluminal stent grafting in the treatment of DeBakey type I aortic dissection.

METHODSFrom September 2007 to January 2010, 6 patients with DeBakey type I aortic dissection (including one with aortic dissection relapse) received ascending aortic (or Bentall) and total aortic arch replacement and simultaneous stent graft implantation into the descending aorta. Multi-slice spiral CT scans (MSCT) were performed in each patient regularly after the surgery. Cardio-pulmonary bypass including deep hypothermic circulatory arrest with selective antegrade cerebral perfusion were used during the surgery.

RESULTSAll the patients recovered smoothly after the surgical procedure without serious complications. The time of cardiopulmonary bypass ranged from 208 to 291 min (mean 242 min), arrest time of the ascending aortic was 112-194 min (mean 145 min), and selective cerebral perfusion time was 63-102 min (mean 76 min). The patients were followed up for 4-32 months (mean 15.5 months), and MSCT revealed smooth blood flow in the prosthesis, complete thrombus formation in the false lumen in the perigraft space and shrinkage of the distal false lumen without internal fistula or stent dislocation.

CONCLUSIONThoracic aortic replacement with concomitant endoluminal stent grafting is a safe and effective treatment of DeBakey type I dissection.