title: Significance of distal fenestration in graft replacement for chronic aortic dissection.
abstract: It is recently controversial whether distal fenestration is necessary in graft replacement for chronic aortic dissection. Several groups started to try the exclusion of intimal entry by the insertion of a stent-graft as a treatment for chronic aortic dissection, while conventional surgical techniques consisted of graft replacement with distal anastomosis to both the true and false channels. It should be kept in mind that the resultant occlusion of the false lumen after obliteration of the false channel could promote spinal cord ischemia. We report a patient with delayed paraplegia after graft replacement without distal fenestration for chronic type B aortic dissection. It is possible that not all cases of chronic aortic dissection are good for stent-grafting.
authors.affiliation: Cardiothoracic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan. jfukada@usa.net
authors.forename: J
authors.initials: J
authors.lastname: Fukada
authors.forename: K
authors.initials: K
authors.lastname: Morishita
authors.forename: S
authors.initials: S
authors.lastname: Naraoka
authors.forename: N
authors.initials: N
authors.lastname: Kawaharada
authors.forename: A
authors.initials: A
authors.lastname: Tabata
authors.forename: H
authors.initials: H
authors.lastname: Hyodoh
authors.forename: T
authors.initials: T
authors.lastname: Abe
mesh_terms: D000784:Aortic Dissection / Q000453:epidemiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000453:epidemiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D015897:Comorbidity; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology