ADULT – Surgical TechniqueA New Graft for Total Arch Replacement With Frozen Elephant Trunk in Type A Dissection
Section snippets
CLINICAL SUMMARY
The SIS graft (Beijing Percutek Therapeutics Co., Ltd., Beijing, China) consists of a proximal tetrafurcated gelatin-coated Dacron prosthesis combined with a distal stented portion (Fig. 1). The most distinctive feature of this graft is the distal stented section: Apart from traditional nitinol ring stents aligned in parallel, it has a nitinol cuff with an adjustable width. After deployment and release of the SIS graft, the cuff would be compressed in width by pulling and tying the attached
DISCUSSION
In experienced centers, TAR with FET has been shown to be a reliable option for arch repair. It eliminates native aortic tissue susceptible to further dilation as much as possible, promoting thrombosis of the false lumen in the distal aorta, remodeling of the aortic wall, and facilitating second-stage aortic replacement. However, extensive arch replacement with this procedure is technically demanding and requires DHCA (18–25 minutes at our center).
The SIS graft proposed in this study greatly
Acknowledgments
We'd like to especially thank Julia Chen from Yale Medical School/New-Haven hospital of Yale University for her valuable suggestions in preparing the manuscript. We also thank Rui Zhao from Fuwai Hospital for video editing.
Reference (1)
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Total arch replacement combined with stented elephant trunk implantation: A new “Standard” therapy for type A dissection involving repair of the aortic arch?
Circulation
(2011)
Cited by (6)
Current Surgical Management of Acute Type A Aortic Dissection in China: A Multicenter Registry Study
2022, JACC: AsiaCitation Excerpt :Some new prostheses, including Thoraflex Hybrid33 and E-Vita Open prostheses,34 are also undergoing clinical trials, which conforms to the trend of aggressive aortic arch treatment worldwide. At present, the medical center of the China Registry of Type A Aortic Dissection is also working closely to complete the clinical trial of sutureless integrated stented grafts.35 This is also the first multicenter study to show the main surgical strategies of ATAAD treatment in China, and subsequent studies will determine the long-term results of this treatment strategy.
Commentary: Total Arch Reconstruction for Acute Type A Aortic Dissection: Keep It Simple
2020, Seminars in Thoracic and Cardiovascular SurgeryIt Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
2021, Frontiers in Cardiovascular MedicineA Novel Sutureless Integrated Stented (SIS) Graft Prosthesis for Type A Aortic Dissection: A Pilot Study for a Prospective, Multicenter Clinical Trial
2021, Frontiers in Cardiovascular MedicineNew-onset postoperative atrial fibrillation after total arch repair is associated with increased in-hospital mortality
2021, Journal of the American Heart Association
Funding: This study was supported by CAMS Initiative for Innovative Medicine (CAMS-I2M). Identification number:2016-I2M-1-016.
Conflicts of Interest: The authors report no conflict of interest relative to this work.