Surgical strategy for treatment of type A aortic dissection with small true lumen of the descending aorta
10.3760/cma.j.cn112434-20200218-00046
- VernacularTitle:A型主动脉夹层合并降主动脉真腔狭小的外科治疗策略
- Author:
Yangfeng TANG
;
Lin HAN
;
Xingli FAN
;
Boyao ZHANG
;
Jiajun ZHANG
;
Qing XUE
;
Jie LU
;
Zhiyun XU
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2021;37(4):208-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the results and methods of surgical treatment for type A aortic dissection with small true lumen of the descending aorta.Methods:9 patients underwent surgical treatment for type A aortic dissection with small true lumen of the descending aorta between January 2017 and December 2019 were analyzed retrospectively. There were 7 males and 2 females, mean age of (41.6±9.2) years. Acute dissection were 2 cases, and chronic dissection were 7 cases. Preoerative computed tomography was used to diagnose the dissection and evaluate the true lumen of the descending aorta. This procedure was done in all patients via a median sternotomy under hypothermic CPB with SCP. 4-branched prosthetic graft was used to replace the ascending aorta and aortic arch. The procedures involving the descending aorta: Hybrid surgery using TEVAR. Distal intimal flap fenestration. Implanting the intraoperative stent-graft or prosthetic graft at false lumen for second-step operation.Results:There was no in-hospital mortality. Stroke, Spinal cord, visceral ischemia and lower limbs malfunction were not observed. Reintervention was not found in case with acute dissection during follow-up. One patient who reveived fenestration underwent TEVAR, others with chronic dissection underwent thoracoabdominal aortic replacement 3 months after surgery.Conclusion:Hybrid or staged procedures was a suitable alternative to patients with type A aortic dissection with small true lumen of the descending aorta.
