Total arch replacement with stented XXXX trunk technique: a proposed treatment for complicated Stanford type B aortic dissection.

@entity1 @entity449 @entity1614 @entity7105 @entity881 @entity451 @entity715
OBJECTIVES: The treatment of Stanford type B aortic dissections involving the arch or associated with proximal @entity449 remains a surgical challenge. We report our results with total arch replacement with the stented @entity7105 trunk (SET) procedure for these complicated Stanford type B aortic dissections. METHODS: Between December 2003 and June 2008, 31 @entity1 were admitted for complicated type B dissection (12 acute, 19 chronic). The mean age at operation was 44.3 +/- 10.6 years (range: 22-68 years). The surgeries were performed by using total arch replacement combined with SET implantation. Enhanced computed tomography (CT) was performed before discharge as well as 3 months and annually to evaluate the condition of the graft and the residual false lumen. RESULTS: The procedure was successful in all but two @entity1 ; two @entity1 died of @entity881 following surgery. No @entity451 was observed after surgery. Follow-up was completed in 27 of 29 @entity1 and the mean follow-up period was 18.4 +/- 12.3 months (range: 6-54 months). During follow-up CT scans, @entity715 formation was observed in the descending aortic false lumen excluded by the stented graft in most @entity1 . One @entity1 died during follow-up while two @entity1 with @entity1614 underwent successful operations for replacement of the remaining descending and abdominal aorta. CONCLUSION: Total arch replacement with the SET procedure has emerged as a viable option for complicated type B dissections and is associated with low morbidity and mortality. At mid-term follow-up, most @entity1 have either thrombosed or have had no further increase in the false lumen of the descending aorta.
