ORIGINAL ARTICLE  CARDIAC SECTION Open access

The Journal of Cardiovascular Surgery 2023 June;64(3):331-7

DOI: 10.23736/S0021-9509.23.12123-9

Copyright © 2023 THE AUTHORS

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language: English

A modified aortic arch “island anastomosis” with stent graft technique for acute type A aortic dissection: a retrospective analysis

Junbo FENG ¹, Yuntao HU ¹, Ya-Peng WANG ^{1, 2}, Juntao LI ¹, Peng PENG ¹, Shenglin GE ¹ ✉

¹ Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei City, China; ² Peking Union Medical College Graduate School, Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, China

BACKGROUND: A modified aortic arch “island anastomosis” with a stent graft technique was used in 33 patients with acute type A aortic dissection. We retrospectively reviewed our experience of this procedure and the short-term follow-up results.
METHODS: This retrospective analysis included 33 patients with acute type A aortic dissection undergoing the modified aortic arch island anastomosis with stent graft procedure. Postoperatively, computed tomography angiography images were obtained before discharge and at 12 months.
RESULTS: All patients underwent successful surgery without intraoperative death. Three patients received dialysis because of postoperative renal insufficiency, 1 patient received tracheotomy because of postoperative respiratory insufficiency, and 5 patients had postoperative delirium. Surgery caused stroke in 1 patient. No paraplegia was found, and no re-exploration for bleeding was performed. One patient died in the hospital due to multiple organ failure, and the other patients were discharged as expected. Only 1 patient had a proximal endoleak, and the patient was stable under close follow-up. The diameter of the descending thoracic aorta was smaller at 12 months postoperatively than preoperatively (34.5±2.5 mm versus 36.7±2.9 mm, P<0.05). The average diameter of the true lumen of the descending thoracic aorta was larger at 12 months postoperatively than preoperatively (24.1±3.1 mm versus 14.9±2.3 mm, P<0.05).
CONCLUSIONS: The modified aortic arch island anastomosis with stent graft technique is a feasible and safety surgical strategy for acute type A aortic dissection. Short-term outcomes are satisfactory.

KEY WORDS: Aortic dissection; Anastomosis, surgical; Stents; Endoleak