Hybrid technique (thoratic aotic replacement combined with endoluminal stent grafting) for aortic dissection

Abstract

Objective To summary the experience of concomitant thoratic aotic replacement and endoluminal stent grafting (socalled'Hybrid technique') for aortic dissection. Methods Four patients with acute Standford type A dissection (dissection located inascending aortic in 2 cases, descending aortic in 1, both ascending and descending aortic in 1 ) received ascending aortic and total aor-tic arch replacement and endoluminal stent grafting. Two cases with chronic Standford type B dissection, located in descending aortic,received descending aortic replaoernent and endoluminal stent grafting. Enhanced electric beam computed tomography (EBCT) wasperformed in each patient at two weeks and three months after surgery to check up the postoperative course. Results All patients suc-cessfully recovered from surgery procedure, time of cardiopulmonary bypass was 38-228 min (mean 92 min), arrest time of ascendingaortic was 118-186 min (mean 136 min) in Standford type A dissection, which time of selective cerebral perfusion was 33-68 min(mean 49 min). Tune of circulation arrest in Standford type B was 22 - 28 min. All patients were discharged from hospital. EBCT in-dicated smooth bloodstream in prosthesis, expansion of residual true lumen and reduction of false lumen, no inner-leak and no endo-stent dislocation at 2 weeks and 3 months after operation. Conclusion Hybrid technique (thoratic aotic replacement combined withendoluminal stent grafting) is a safe, effective and economic surgical treatment for complex aortic dissection. Key words: Aorta Aneurysm, dissecting Blood vessel prosthesis Cardiac surgical procedures Stent