Efficacy comparison between total aortic arch reconstruction with open placement of triple-branched stent graft and total aortic replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection
10.3760/cma.j.issn.0253-3758.2012.08.011
- VernacularTitle:三分支覆膜支架重建主动脉弓部手术治疗Stanford A型主动脉夹层的疗效
- Author:
Yun-Hua SHEN
1
;
Zhong-Ya YAN
;
Qing-Chun ZHANG
;
Zhong LU
;
Zheng-Yan ZHU
;
Guang-Cun CHENG
;
Yun SUN
;
Li ZHENG
;
Yi-Jun WU
Author Information
1. 安徽医科大学附属省立医院
- Keywords:
Aortic diseases;
Stents;
Treatment outcome
- From:
Chinese Journal of Cardiology
2012;40(8):676-680
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy between total aortic arch reconstruction with open triple-branched stent graft placement and total aortic replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection.Methods Patients with Stanford A aortic dissection treated with surgical treatment from January 2006 to May 2011 were included in this study.The patients were divided into two groups.Group Ⅰ (n =20) patients were treated by total arch replacement with stented elephant trunk procedure.Group Ⅱ (n =8 ) patients received open triple-branched stent graft placement. Echocardiography and aortic CT angiography were performed before and at 1 month after operation.Results Age,gender and disease severity were similar between the 2 groups ( all P ＞ 0.05 ).Operation was successful in all 28 patients.Cardiopulmonary bypass time,aortic cross clamp time,circulation arrest time and duration of ventilator assisted breathing were significantly longer; postoperative drainage volume and blood transfusion volume were significantly larger and hospitalization cost was significantly higher in group Ⅰ patients compared those in group Ⅱ patients ( all P ＜ 0.05 ). One month after operation,the maximum internal diameter of aorta was smaller than pre-operation in both group Ⅰ [ (30.2 ± 3.1 ) mm vs.(42.5 ±6.5)mm,P ＜ 0.05] and group Ⅱ [(31.5 ±2.5) mm vs.(44.1 ±7.3)mm,P ＜ 0.05].Conclusions Short-term procedural success rate was similar between the two groups.The total aortic arch reconstruction with open triple-branched stent graft placement procedure is simpler,shortens the operation time,reduces the blood transfusion volume and is more cost-effective compared to the classical aortic arch operation.
