• J. Thorac. Cardiovasc. Surg. · May 2022

    Early outcomes with a hybrid technique for repair of a non-A non-B aortic dissection.

    • Weitie Wang, Hulin Piao, Yong Wang, Bo Li, Zhicheng Zhu, Tiance Wang, and Kexiang Liu.
    • Department of Cardiovascular Surgery, the Second Hospital of Jilin University, Changchun, Jilin, China.
    • J. Thorac. Cardiovasc. Surg. 2022 May 1; 163 (5): 1766-1774.

    ObjectiveThis study reports the early outcomes of patients with acute non-A non-B aortic dissection that involved the aortic arch but not the ascending aorta.MethodsFrom January 2013 to December 2018, 825 patients presented with aortic dissection. Of these, 28 patients with non-A non-B dissection (classified as dissection extending into the aortic arch with entry between the left common carotid artery and the left subclavian arteries) underwent a novel hybrid surgery. Self modified stent-grafts (Micropart Corp, Shanghai, China) were implanted via median sternotomy. Clinical presentation, postoperative data, and early outcomes were recorded.ResultsAll patients underwent an emergency operation. There were no in-hospital mortalities, reexplorations for hemorrhage, reports of paraplegia, cerebral infarctions, endoleaks, or left subclavian artery occlusions. No blood products were required during or after the operations. During the early follow-up at 39.12 ± 15.04 months (6.0-74.0 months), 1 patient was lost to follow-up, and 1 patient died suddenly. Computed tomography angiography showed false lumen patency persisted in the aortic arch and descending aorta without any symptoms. The 6-month computed tomography angiography showed significantly smaller distal aortic arch diameters (31.94 ± 6.95 mm) and descending aorta diameters (34.84 ± 4.15 mm) than measured preoperatively (36.76 ± 4.15 mm and 37.31 ± 4.7 mm, respectively). No paraplegia, cerebral infarction, upper limb ischemia, or left subclavian artery ischemia events were reported.ConclusionsOur inclusion aortic arch technique is a safe, effective, and simple treatment for non-A non-B aortic dissections that can avoid endoleaks, requires no blood products, and has satisfactory early outcomes.Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.

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