This Article Full Text Full Text (PDF) On-line Video Alert me when this article is cited Alert me if a correction is posted 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 Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chen, I-M. Articles by Shih, C.-C. Search for Related Content PubMed PubMed Citation Articles by Chen, I-M. Articles by Shih, C.-C.

Extending hybrid approach to residual Stanford type A dissecting aortic aneurysm

^a Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei 112, Taiwan
^b School of Medicine, National Yang-Ming University, Taipei, Taiwan
^c Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

*Corresponding author. Tel.: +886-2-2875-7495; fax: +886-2-2875-7656.

E-mail address: ccshih{at}vghtpe.gov.tw (C.-C. Shih).

Residual Stanford type A dissecting aortic aneurysm was frequently encountered several years after emergent repair. Surgical approach remained challenging and hazardous, not only due to the extensive involvement of the dilated false lumen but also the high comorbility of redo sternotomy and extensive thoraco-abdominal procedure. We present a modified hybrid technique incorporating arch replacement with bifurcated graft to relocate supra-aortic branches followed by anastomosis with reverse sleeve graft of elephant trunk over distal arch. After stent graft insertion over proper landing zone, all the communicating holes could be sealed and the compressed true lumen of descending aorta would be fully dilated. This technique not only simplified some laborious situations but also simultaneously resolved the entire thoracic dissection segment with an acceptable and optimal midterm result.

Key Words: Aortic dissection; Aortic operation; Endovascular procedures/stents