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Application of the modified stented elephant trunk procedure in type B aortic dissection
Honglei Zhao1, Tao Bai1, Jinrong Xue1
1Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Aortic Disease Center, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China.
A modified stented elephant trunk (SET) procedure offers a safe and effective treatment for complicated Stanford type B aortic dissection (TBAD). This approach anticipates future interventions, demonstrating positive outcomes in a recent patient cohort.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Complicated Stanford type B aortic dissection (TBAD) is progressive and requires surgical strategies that accommodate future interventions.
- The modified stented elephant trunk (SET) procedure has emerged as a potential treatment for these complex cases.
- Reviewing the indications, planning, and operative details of the modified SET procedure is crucial for its application.
Purpose of the Study:
- To evaluate the safety and efficiency of a modified stented elephant trunk (SET) procedure for treating complicated Stanford type B aortic dissection (TBAD).
- To present the indications, planning considerations, and operative details of this modified SET technique.
Main Methods:
- A cohort of ten patients with complicated TBAD underwent the modified SET procedure between January and December 2019.
- The procedure involved deep hypothermic circulatory arrest and SET implantation via an aortic arch incision.
- Post-operative computed tomography angiography (CTA) was used to assess procedural safety and accuracy.
Main Results:
- The study reported specific surgical times including cardiopulmonary bypass (138.6±15.64 min) and selective cerebral perfusion (21.7±5.56 min).
- Key physiological parameters during selective cerebral perfusion were maintained within safe ranges.
- No mortality, endoleakage, or neurological complications were observed in the post-operative period, with short ICU and hospitalization times.
Conclusions:
- The modified stented elephant trunk procedure is a safe and efficient surgical option for managing complicated Stanford type B aortic dissection.
- This technique demonstrates favorable short-term outcomes, including the absence of major complications.
