This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Lennart Duebener Armin Erasmi Hans-Hinrich Sievers Martin Misfeld Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Duebener, L. Articles by Misfeld, M. Search for Related Content PubMed PubMed Citation Articles by Duebener, L. Articles by Misfeld, M. Related Collections Great vessels

Surgical interventions after emergency endovascular stent-grafting for acute type B aortic dissections

^a Department of Cardiac Surgery, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
^b Departments of Cardiology, University Hospital of Schleswig-Holstein, Campus Luebeck, Germany
^c Department of Cardiology, Heart Center Bad Segeberg, Germany

*Corresponding author. Tel.: +49 451 500 2108; fax: +49 451 500 2051.

E-mail address: sievers{at}mu-luebeck.de (H.-H. Sievers).

In this retrospective study we reviewed our results of secondary surgery for complications after emergency placement of aortic stents for acute type B dissection. From October 2000 to June 2006, endovascular stent-grafting (ESG) was performed in 13 patients as an emergency procedure for acute type B dissection. Self-expanding nitinol stents (mean diameter 39.8±4.7 mm) were placed into the descending aorta distal to the left subclavian artery. In-hospital mortality was 15.4% (2/13) and related to persistent visceral malperfusion. Three patients (23%) required consecutive open surgery of the thoracic aorta after emergency endovascular stent-grafting for acute type B dissection. Indications for surgery included acute development of retrograde type A aortic dissection and acute stent dislocation by fractured wires and secondary leakage. Elective surgery was necessary in one patient 6 months after stent-grafting for late formation of an aneurysm of the descending aorta. There were no deaths or major morbidity after surgery of the thoracic aorta early or during follow-up. Mean follow-up was 38.0±13.9 months (range 1–70 months) and complete. We conclude from our study that stent-grafting of the descending aorta is a feasible, relatively safe and effective approach even in the emergency treatment of patients with complicated acute type B dissection. However, in a relevant number of patients emergency stent-grafting for acute type B aortic dissection results in complications that require secondary surgical treatment.

Key Words: Aortic dissection; Descending aorta; Stent-grafting; Retrograde dissection; Visceral ischemia

This article has been cited by other articles:

				Z. H. Dong, W. G. Fu, Y. Q. Wang, D. Q. Guo, X. Xu, Y. Ji, B. Chen, J. H. Jiang, J. Yang, Z. Y. Shi, et al. Retrograde Type A Aortic Dissection After Endovascular Stent Graft Placement for Treatment of Type B Dissection Circulation, February 10, 2009; 119(5): 735 - 741. [Abstract] [Full Text] [PDF]