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  • Oral presentation
  • Open Access

The comparison of the results of surgical treatment («elephant trunk» operation and hybrid technique with stent-graft implantation) of the thoracic aorta dissection type A

  • 1Email author,
  • 2,
  • 1,
  • 1,
  • 1 and
  • 1
Journal of Cardiothoracic Surgery20138 (Suppl 1) :O38

https://doi.org/10.1186/1749-8090-8-S1-O38

  • Published:

Keywords

  • Thoracic Aorta
  • Arteria Subclavia
  • Brain Edema
  • Hybrid Technique
  • False Lumen

Background

The aim of this research was to compare the results of surgical treatment of the thoracic aorta dissection type A in patients who underwent «elephant trunk» operation and hybrid technique with stent-graft implantation.

Methods

94 atients (mean age 48,7, males – 79) patients with type A dissection of the thoracic aorta (DeBeckey 1) within the period from 2001 to May, 2013 were operated. The 59 patients underwent «elephant trunk» operation – group A, 35 were operated with hybrid technique ( E-vita Open stent-graft implantation) – group B. Aortic valve sparing was used in 58 (61,7%) cases. Extra corporeal circulation throught arteria subclavia dextra – venae cavae was peformed. Cerebral and visceral protection were carried out with unilateral cerebral perfusion throught arteria subclavia dextra and additional contour for perfusion of the lower body. Deep 18-28ºC and moderate hypothermia till 28ºC were used.

Results

Total hospital mortality was 25 patients (26,6%): group A 28,8% and group B 25,7% . 1- and 5-year survival rate are 88,1% and 76,2% in group A, 92,3% and 88,3% in group B accordingly. Such complications as bleeding (14%, 10%), brain edema (8,8%, 0%), spinal stroke (3,5%, 5,7%), renal failure occurred (17,9%, 17,5%) in both group A and B accordingly.

Conclusion

Stent-graft implantation in patients with type A dissection during open heart surgery is more effective in reconstruction of the aorta and the false lumen elimination in descend aorta in comparison with an «elephant trunk» operation.

Authors’ Affiliations

(1)
Cardio-Surgery Department №2, RSPC "Cardiology", Minsk, Belarus
(2)
Laboratory of Heart Surgery, RSPC "Cardiology", Minsk, Belarus

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