Open stented elephant trunk for complicated Stanford type B aortic dissection: a single-center experience
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(2020) 15:282
RESEARCH ARTICLE
Open Access
Open stented elephant trunk for complicated Stanford type B aortic dissection: a single-center experience Hongtao Tie1†, Lingwen Kong2†, Zhengjie Tu1†, Dan Chen1, Delai Zheng1, Qingchen Wu1 and Qiang Li1*
Abstract Background: Open stented elephant trunk (SET) or SET with left subclavian artery (LSCA) to left common carotid artery (LCCA) bypass is proven to a potentially alternative treatment for complicated Stanford type B aortic dissection (TBAD). In the current study, we reported our experience with ten consecutive TBAD patients who underwent open SET. Methods: Patients with complicated TBAD underwent open SET from May 2016 to November 2018 in our institution were included. Patients’ clinical data were obtained from the electronic medical record system, and longterm clinical outcomes were collected by telephone interviews or outpatient interviews. Results: A total of ten patients with nine males and one female were included, and the average age was 47.3 (31– 65) years. Increased D-dimer and fibrinogen degradation products were observed in all patients at admission, and two patients had renal insufficiency. The average postoperative mechanical ventilation time, length of stay in intensive care unit, and postoperative hospital length of stay were 46.9 (6.7–151.2) hours, 7.7 (4–17) days, and 15.7 (10–26) days. No postoperative death occurred. Acute kidney injury and other complications were observed, and they were recovered well when discharge. In long-term follow-up, computed tomography angiography indicated that aortas were completely well remodeled, and blood supply of the brachiocephalic trunks was normal without anastomotic complications. All patients lived well. Conclusion: SET or SET with subclavian artery correction shows satisfactory clinical outcomes, and it could be considered as an alternative treatment. Well-designed, large-scale studies with long-term follow-up are still needed. Keywords: Complicated Stanford type B aortic dissection, Stented elephant trunk, Subclavian artery correction
Background Aortic dissection (AD) is a life-threatening disease, characterized by rapid blood flowing into the media and separating the intima and the adventitia apart. It was estimated that the annual incidence of AD ranged from 2·9 to 3·5 per 100,000 population [1]. The actual * Correspondence: [email protected] † Hongtao Tie, Lingwen Kong and Zhengjie Tu contributed equally to this work. 1 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China Full list of author information is available at the end of the article
incidence is higher because of deaths before hospital admission [2, 3] and increasing with the population aging [4]. About 25 to 40% AD is type Stanford type B, characterized by an intimal tear in the descending aorta without the extension of ascending aorta involved. Stanford type B AD (TBAD) is classified as uncomplicated and complicated ones. Though TBAD is tended to have a stable in-hospit
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