Surgical treatment of distal aortic arch lesions using stented elephant trunk implantation combined with transposition of left subclavian artery to left common carotid artery

QI Ruidong; Zhu Junming; Chen Lei; LI Chengnan; Qiao Zhiyu; Chen Lijian; GE Yipeng; HU Haiou; Xia Yu; Xing Xiaoyan; Zheng Tie; Sun Lizhong

Return

Surgical treatment of distal aortic arch lesions using stented elephant trunk implantation combined with transposition of left subclavian artery to left common carotid artery

VernacularTitle:左锁骨下动脉-左颈总动脉转流术联合支架象鼻术治疗主动脉弓远端病变
Author: QI Ruidong ^{1
,

2} ; ZHU Junming ^{1
,

2} ; CHEN Lei ^{1
,

2} ; LI Chengnan ^{1
,

2} ; QIAO Zhiyu ^{1
,

2} ; CHEN Lijian ^{1
,

2} ; GE Yipeng ^{1
,

2} ; HU Haiou ^{1
,

2} ; XIA Yu ^{1
,

2} ; XING Xiaoyan ^{1
,

2} ; ZHENG Tie ^{1
,

2} ; SUN Lizhong ^{1
,

2}
Author Information

1. Beijing Aortic Disease Center, Beijing Institute of Heart, Lung and Blood Vessel Diseases &
2. Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P.R.China
Publication Type:Journal Article
Keywords: Distal aortic arch lesions; stented elephant trunk procedure; left subclavain artery transposition
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2018;25(1):49-53
CountryChina
Language:Chinese
Abstract: Objective To evaluate the short- and middle-term outcomes of surgical treatment for distal aortic arch lesions using stented elephant trunk implantation combined with transposition of left subclavian artery to left common carotid artery. Methods The clinical data of 14 patients with distal aortic arch lesions undergoing stented elephant trunk procedure with left subclavain artery transposition under hypothermic cardiopulmonary bypass (CPB) with antegrade selective cerebral perfusion from May 2009 to November 2015 in our hospital were retrospectively reviewed. All of them were males with a mean age of 52±14 years ranging from 20 to 69 years. Hypertension was observed in nine patients, coronary artery disease in five and prior cerebral infarction in one. History of percutaneous coronary intervention was noted in one patient, history of Bentall operation in one, ligation of patent ductus arteriosus in one and endovascular aneurysm repair in one. Results There was no hospital death. Concomitant procedures included coronary artery bypass grafting in two patients and plasty of the ascending aorta replacement in one. Mean duration of mechanical ventilation and ICU stay was 21±7 h and 43±19 h, respectively. All patients survived and were discharged. One patient was lost to follow-up and no patient died during the follow-up. Postoperative computed tomography revealed good patency of the anastomotic site between the left subclavian artery and the left common carotid artery. Conclusion Stented elephant trunk procedure with left subclavain artery transposition obtains satisfactory surgical results in patients with distal aortic arch lesions.