[Bentall operation combined with total arch replacement and stented elephant trunk implantation for serious Debakey I aortic dissecting aneurysm].

Abstract

OBJECTIVE:

To summarize the clinical experience of Bentall operation combined with total arch replacement and stented elephant trunk implantation for serious Debakey I aortic dissecting aneurysm.

METHODS:

Twelve patients with serious Debakey I aortic dissecting aneurysm underwent surgical treatment from January 2005 to December 2007. There were 10 male and 2 female with the mean age of (40.1 +/- 9.5) years old. There were acute aortic dissection in 9 cases, chronic aortic dissection in 3 cases. The inner diameter of aorta was (5.3 +/- 1.8) cm. There were Marfan syndrome in 4 cases, aortic regurgitation in all cases, severely persistent chest pain in 9 cases, acute left heart failure in 8 cases, and cardiac tamponade in 4 cases. Bentall operations combined with total arch replacement and stented elephant trunk implantation were performed by using deep hypothermic circulatory arrest and antegrade selective cerebral perfusion in all cases.

RESULTS:

Urgent surgery underwent in 9 cases. The mean interval between the onset of aortic dissection and the accomplishment of surgery was (41.0 +/- 15.9) hours. Cardiopulmonary bypass time was (191 +/- 26) min, average cross clamp time was (134 +/- 31) min, and average deep hypothermic circulatory arrest time was (50.0 +/- 14.5) min. One patient died in hospital. The time stayed in ICU was 3 to 27 d. Mental disorder in 6 cases, hemi-paralysis in 1 case, amputation in 1 case, hemorrhage of anastomosis in 1 case, hemorrhage of alimentary tract in 1 case, and pleural effusion in 4 cases were recorded. Eleven cases were followed-up for 8 weeks to 36 months. There were no bending of the stents and no obstruction in the vascular prosthesis.No re-operation was needed. One case died 6 months postoperatively.

CONCLUSION:

Bentall operation combined with total arch replacement and stented elephant trunk implantation is safe and effective for serious Debakey I aortic dissecting aneurysm, while good organs protection and consummate cardiopulmonary bypass were taken.

• Authors: Tian-Xiang Gu, Chun Wang, Yu-Hai Zhang
• Journal: Zhonghua wai ke za zhi [Chinese journal of surgery] (Zhonghua Wai Ke Za Zhi) Vol. 46 Issue 23 Pg. 1816-8 (Dec 01 2008) ISSN: 0529-5815 [Print] China
• PMID: 19094796 (Publication Type: English Abstract, Journal Article)

Topics

• Adult
• Aortic Dissection (surgery)
• Aorta (surgery)
• Aortic Aneurysm, Thoracic (surgery)
• Blood Vessel Prosthesis Implantation
• Circulatory Arrest, Deep Hypothermia Induced
• Female
• Humans
• Male
• Middle Aged
• Stents
• Treatment Outcome