One-Stage Repair of Acute Type B Dissection With Ascending Thoracic Aortic Dilatation Using a Stented Elephant Trunk Procedure

2015 ◽  
Vol 30 (10) ◽  
pp. 756-760 ◽  
Author(s):  
Ming Li ◽  
Rui-Dong Qi ◽  
Jun-Ming Zhu ◽  
Yong-Min Liu ◽  
Jun Zheng ◽  
...  
Keyword(s):  
Aortic Dilatation ◽  
Acute Type ◽  
Type B ◽  
Elephant Trunk ◽  
One Stage ◽  
Type B Dissection ◽  
Elephant Trunk Procedure

scholarly journals A Case of Abdominal Aortic Aneurysm Involved by Acute Type B Dissection Treated with One-Stage OPCAB and Y-Graft Replacement

2005 ◽  
Vol 34 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Yoshimori Araki ◽  
Michio Sasaki ◽  
Toshiaki Akita ◽  
Akihiko Usui ◽  
Kazuo Nishimoto ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Acute Type ◽  
Type B ◽  
Graft Replacement ◽  
One Stage ◽  
Abdominal Aortic ◽  
Type B Dissection

scholarly journals Frozen Elephant Trunk for Acute Type B Dissection Involving the Distal Arch in the Hybrid Repair Era

2018 ◽  
Vol 106 (4) ◽  
pp. 1182-1188 ◽  
Author(s):  
Rui-Dong Qi ◽  
Jun-Ming Zhu ◽  
Yong-Min Liu ◽  
Lei Chen ◽  
Cheng-Nan Li ◽  
...  
Keyword(s):  
Acute Type ◽  
Type B ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type B Dissection ◽  
Hybrid Repair

scholarly journals Clinical outcomes of the Frozen Elephant Trunk procedure in 70 emergent and elective patients undergoing aortic arch surgery: the Salerno experience with Thoraflex Hybrid

2021 ◽  
Author(s):  
Paolo Masiello ◽  
Generoso Mastrogiovanni ◽  
Oreste Presutto ◽  
Pierpaolo Chivasso ◽  
Vito Bruno ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Clinical Outcomes ◽  
Type A ◽  
Aortic Aneurysms ◽  
Acute Type ◽  
Type B ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type B Dissection ◽  
Aortic Dissections

Background and aim of the study. To report early clinical outcomes of the frozen elephant trunk technique (FET) for the treatment of complex aortic diseases after transition from conventional elephant trunk. Methods. A single-center, retrospective study of patients who underwent hybrid aortic arch and FET repair for aortic arch and/or proximal descending aortic aneurysms, acute and chronic Stanford type A aortic dissection with arch and/or proximal descending involvement, Stanford type B acute and chronic aortic dissections with retrograde aortic arch involvement. Results. Between December 2017 and May 2020, 70 consecutive patients (62.7±10.6 years, 59 male) were treated: 41 (58.6%) for acute conditions and 29 (41.4%) for chronic. Technical success was 100%. In-hospital mortality was 14.2% (n=12, 17.1% emergency vs. 10.3% chronic, P=NS); 2 (2.9%) major strokes; 1 (1.4%) spinal cord injury. Follow-up was 12.5 months (IQR 3.7—22.3. Overall survival at 3, 6, 12 and 24 months was 90% (95% CI, 83.2—97.3), 85.6% (95% CI, 77.7—94.3), 79.1% (95% CI, 69.9—89.5), 75.6% (95% CI, 65.8—86.9) and 73.5 (95% CI, 63.3—85.3). There were no aortic re-interventions and no dSINE; 5 patients with residual type B dissection underwent TEVAR completion. Conclusions. In a real-world setting, FET demonstrated a rapid learning curve and good clinical outcomes, even in acute type A aortic dissections. Techniques to perfect the procedure and to reduce remaining risks, and consensus on considerations such as standardized cerebral protection need to be reported.

Repair of Chronic Type B Dissection With Aortic Arch Involvement Using a Stented Elephant Trunk Procedure

2010 ◽  
Vol 90 (1) ◽  
pp. 95-100 ◽  
Author(s):  
LiZhong Sun ◽  
Xin Zhao ◽  
Qian Chang ◽  
JunMing Zhu ◽  
YongMin Liu ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Type B ◽  
Chronic Type ◽  
Elephant Trunk ◽  
Type B Dissection ◽  
Elephant Trunk Procedure

scholarly journals Visceral hybrid reconstruction of thoracoabdominal aortic aneurysm after open repair of type a aortic dissection by the Bentall procedure with the elephant trunk technique: A case report

2014 ◽  
Vol 71 (9) ◽  
pp. 879-883 ◽  
Author(s):  
Ivan Marjanovic ◽  
Momir Sarac ◽  
Aleksandar Tomic ◽  
Sinisa Rusovic ◽  
Leposava Sekulovic ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Type B ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Bentall Procedure ◽  
Type B Dissection ◽  
Elephant Trunk Technique

Introduction. Reconstruction of chronic type B dissection and thoracoabdominal aortic aneurysm (TAAA) remaining after the emergency reconstruction of the ascending thoracic aorta and aortic arch for acute type A dissection represents one of the major surgical challenges. Complications of chronic type B dissection are aneurysmal formation and rupture of an aortic aneurysm with a high mortality rate. We presented a case of visceral hybrid reconstruction of TAAA secondary to chronic dissection type B after the Bentall procedure with the elephant trunk technique due to acute type A aortic dissection in a high-risk patient. Case report. A 62 year-old woman was admitted to our institution for reconstruction of Crawford type I TAAA secondary to chronic dissection. The patient had had an acute type A aortic dissection 3 years before and undergone reconstruction by the Bentall procedure with the elephant trunk technique with valve replacement. On admission the patient had coronary artery disease (myocardial infarction, two times in the past 3 years), congestive heart disease with ejection fraction of 25% and chronic obstructive pulmonary disease. On computed tomography (CT) of the aorta TAAA was revealed with a maximum diameter of 93 mm in the descending thoracic aorta secondary to chronic dissection. All the visceral arteries originated from the true lumen with exception of the celiac artery (CA), and the end of chronic dissection was below the origin of the superior mesenteric artery (SMA). The patient was operated on using surgical visceral reconstruction of the SMA, CA and the right renal artery (RRA) as the first procedure. Postoperative course was without complications. Endovascular TAAA reconstruction was performed as the second procedure one month later, when the elephant trunk was used as the proximal landing zone for the endograft, and distal landing zone was the level of origin of the RRA. Postoperatively, the patient had no neurological deficit and renal, liver function and functions of the other abdominal organs were normal. Control CT after 6 months showed full exclusion of the aneurysm from the systemic circulation without endoleak and good flow through visceral anastomosis. Conclusion. In patients with comorbidities, like in the presented case, visceral hybrid reconstruction of chronic dissection type B with TAAA could be the treatment of choice.

Determining Surgical Indications for Acute Type B Dissection Based on Enlargement of Aortic Diameter During the Chronic Phase

Circulation ◽  
1995 ◽  
Vol 92 (9) ◽  
pp. 107-112 ◽  
Author(s):  
Masaaki Kato ◽  
Hong-zhi Bai ◽  
Kenji Sato ◽  
Seiichi Kawamoto ◽  
Mitsunori Kaneko ◽  
...  
Keyword(s):  
Chronic Phase ◽  
Aortic Diameter ◽  
Acute Type ◽  
Type B ◽  
Surgical Indications ◽  
Type B Dissection

Endovascular Therapy for Nonischemic vs Ischemic Complicated Acute Type B Aortic Dissection

2019 ◽  
Vol 27 (1) ◽  
pp. 145-152 ◽  
Author(s):  
Ahmed Eleshra ◽  
Tilo Kölbel ◽  
Giuseppe Panuccio ◽  
Fiona Rohlffs ◽  
E. Sebastian Debus ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Uncontrolled Hypertension ◽  
Aortic Dilatation ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Ischemic Group ◽  
Atherosclerotic Stenosis ◽  
Significant Difference ◽  
Branch Vessel

Purpose: To report a single-center experience with thoracic endovascular aortic repair (TEVAR) for complicated acute type B aortic dissection (cATBAD) comparing patients with vs without end-organ ischemia. Materials and Methods: Between November 2010 and December 2017, 64 patients (mean age 64.8±12.5 years; 49 men) underwent TEVAR for cATBAD. Patients were grouped into 2 cohorts: nonischemic (39, 61%) patients with unrelenting pain, early progressive aortic dilatation, uncontrolled hypertension, or rupture, and ischemic (25, 39%) patients with visceral, renal, lower extremity, or spinal cord hypoperfusion. Results: Mean time from diagnosis to treatment was 7.5 days (range 1–32) in the nonischemic group vs 2.3 days (range 1–14) days in the ischemic group (p=0.007). Fourteen (56%) of 25 ischemic cATBAD patients had stents implanted in the renovascular branch vessels, while 4 (16%) patients had stents implanted in the iliac arteries. When branch vessel cannulation failed, fenestrations were made in the intimal flap to improve perfusion of the involved branch (n=5). In the nonischemic group, 3 arteries were stented owing to atherosclerotic stenosis. Technical success was achieved in 62 (97%) of 64 patients; despite stenting, 2 patients had low renal artery perfusion on final angiography. There were no statistically significant differences in early or late outcomes between the nonischemic vs ischemic cATBAD patients. Six (9%) patients died within 30 days: 2 (5%) in the nonischemic group vs 4 (16%) in the ischemic group. Major complications (1 stroke, 2 cases of paraplegia, 1 retrograde type A dissection, and 1 case of bowel ischemia) occurred only in the nonischemic group. The mean follow-up was 28 months. Late endoleaks were observed in 3 (8%) nonischemic patients and 1 (4%) ischemic patient. Reinterventions were required in 7 (18%) nonischemic patients and 4 (16%) ischemic patients. Conclusion: TEVAR is an effective and safe method of treating cATBAD. Early intervention in ischemic cATBAD may have played a significant role in the lack of significant difference between ischemic and nonischemic cATBAD outcomes. Direct visceral reperfusion through branch vessel stenting during TEVAR may be crucial in achieving good outcomes in ischemic cATBAD.

scholarly journals Complicated acute type B dissection originating from an aberrant right subclavian artery

2014 ◽  
Vol 46 (1) ◽  
pp. e20-e20 ◽  
Author(s):  
Gioia Di Stefano ◽  
Michele Murzi ◽  
Marco Solinas ◽  
Mattia Glauber
Keyword(s):  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Acute Type ◽  
Type B ◽  
Type B Dissection
Sign in / Sign up

Export Citation Format

Share Document