BACKGROUND: We evaluated an open stented elephant trunk (sET) technique combined with cardiac operations for a one-stage treatment of patients with complicated Stanford type B aortic dissection (AoD) and cardiac diseases. METHODS: Between April 2007 and March 2010, 16 patients with Stanford B AoD and cardiac diseases (mean age 49.75 ± 13.42 years) underwent sET combined with cardiac operations. Under deep hypothermic cardiac arrest (DHCA), a stented graft was directly delivered via the incision of aortic arch and the proximal graft was sutured on the normal distal aortic arch wall in a continuous circumferential full-thickness fashion. The combined cardiac operations (Bentall procedure, etc.) were performed before sET implantation while cooling. RESULTS: Average time of cardiopulmonary bypass, aortic cross clamping durance, and DHCA was 131.62 ± 23.85, 64.69 ± 9.72, and 21.94 ± 3.60 minutes, respectively. There were no early deaths and no neurological complications. During a follow-up of 18.69 ± 9.94 months, computed tomographic angiography was performed in all patients. Neither endoleak nor stent shifting was observed. Retrograde type A AoD was not found during follow-up. Thrombus was formed in the false lumen from the proximal descending aorta to the diaphragmatic section. CONCLUSIONS: The open sET technique combined cardiac procedures can reliably treat Stanford type B AoD concomitant with surgical cardiac disease in a single stage. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
BACKGROUND: We evaluated an open stented elephant trunk (sET) technique combined with cardiac operations for a one-stage treatment of patients with complicated Stanford type B aortic dissection (AoD) and cardiac diseases. METHODS: Between April 2007 and March 2010, 16 patients with Stanford B AoD and cardiac diseases (mean age 49.75 ± 13.42 years) underwent sET combined with cardiac operations. Under deep hypothermic cardiac arrest (DHCA), a stented graft was directly delivered via the incision of aortic arch and the proximal graft was sutured on the normal distal aortic arch wall in a continuous circumferential full-thickness fashion. The combined cardiac operations (Bentall procedure, etc.) were performed before sET implantation while cooling. RESULTS: Average time of cardiopulmonary bypass, aortic cross clamping durance, and DHCA was 131.62 ± 23.85, 64.69 ± 9.72, and 21.94 ± 3.60 minutes, respectively. There were no early deaths and no neurological complications. During a follow-up of 18.69 ± 9.94 months, computed tomographic angiography was performed in all patients. Neither endoleak nor stent shifting was observed. Retrograde type A AoD was not found during follow-up. Thrombus was formed in the false lumen from the proximal descending aorta to the diaphragmatic section. CONCLUSIONS: The open sET technique combined cardiac procedures can reliably treat Stanford type B AoD concomitant with surgical cardiac disease in a single stage. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.