[Echocardiography guided coated stent-graft implantation for patients with Stanford B aortic dissection]

To evaluate the feasibility, safety and efficacy of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) guided coated stent-graft implantation for patients with Stanford B aortic dissection.

In 5 patients with CT confirmed Stanford B aortic dissection, TEE and TTE were used to determine the parameters for pre-surgery diagnosis and selection of suitable coated stent. During surgery, TEE and TTE provided real-time and dynamic monitoring and guiding for precise implantation of the coated stent to effectively seal the tear of the aortic dissection. After surgery, efficacy of implanted coated stent was evaluated by TTE.

In all 5 patients, the coated stents were successfully implanted in the true lumen, a small distal tear was not covered in 1 case. Displacement of stent-graft or new endoleak was not observed at follow-up examinations performed at 3 months post-surgery. There were no aortic perforation, renal failure, paraplegia or other complications. The medians of left ventricular ejection fraction (LVEF) in 2 days before surgery, 1 month post-surgery and 3 months post-surgery are 59.9%, 67.4% and 68.1% and the medians of fraction shortening (FS) are 31.4%, 33.7% and 39.1%. Compared with 2 days before surgery, significant increase of LVEF and FS was observed in 1 month post-surgery and 3 months post-surgery (all P < 0.05).

Our results showed that echocardiography guided coated stent-graft implantation for patients with Stanford B aortic dissection was safe and effective with lower risk of complications.