Original title: Application of Open Triple-Branch Aortic Arch Stent Graff for Acute Stanford Type A Aortic Dissection Reference: Fei Hua, et; al. Vascular Endovascular Surgery 47;2:109-14

Type A aortic dissection is a disease of high morbidity and mortality, especially in the early hours . Surgery is the treatment of choice but still have a significant complication rate .

We analyzed 34 patients with type A aortic dissection treated with branched stent for neck vessels ( Aortec Medical Technology Co Ltd , Beijing , China ) and were compared with 16 patients who underwent conventional surgery . No significant differences in baseline characteristics of both groups.

The procedure was performed under general anesthesia with median stereotomy, cardiopulmonary bypass , blood cardioplegia and deep hypothermia before implantation of the stent and its branches. The group that received stents had lower cardiopulmonary bypass time ( 186 ± 38 min . Versus 204 ± 47 min .), lower myocardial ischemic  time ( 101 ± 27 min . Versus 119 ± 30 min .) , shorter selective brain perfusion time ( 39 ± 11 min . Versus 46 ± 11 min . ) , as well as mechanical ventilation assistance  (19.9 ± 3.4 hours versus 20.4 ± 3.7 hours. ) And stay in intensive care (82.1 ± 11.2 hours. Versus  89.2 ± 13.1 hours.) During hospitalization 2 patients died, one required dialysis , 2 evolved with arm mobility impairments and one  presented consciousness disorders. At 9.6 months (2-24 months) follow-up , no patient died and only one had right arm motility difficulty  and required rehabilitation. Control tomography was performed in all patients witnessing a correct stent implantation with the preserved flow in the legs without significant leaks .

Conclusion:

This stent would be useful for those patients who require surgical reconstruction of the thoracic aorta , thus reducing the time of cardiopulmonary bypass from traditional surgery and potential complications thereof . 

Comment:

While this is a small population, indicates that it was possible to satisfactory solve, with this strategy favorably resolve such a complex disease , reducing surgical time and intensive areas and a good performance in the medium term. 

Courtesy by Dr Carlos Fava
Interventional Cardiologist
Favaloro Foundation
Buenos Aires – Argentina

Dr. Carlos Fava para SOLACI.ORG