[Interventional treatment of thoracic aortic dissection with stent-graft placement guided by transesophageal echocardiography].
OBJECTIVE
To evaluate the effect and safety of transfemoral stent-graft placement in combination with transesophageal echocardiography (TEE) in treating DeBakey IIIb aortic dissecting aneurysm.


METHODS
Eight male patients [mean age (55.8 +/- 10.2) years, range 28-71 years] with DeBakey IIIb aortic dissection were diagnosed and confirmed by magnetic resonance angiography (MRA). With TEE and fluoroscopy monitoring, transfemoral stent-grafts placement was performed with resulting close of the proximal or both proximal and distal ruptures of aortic dissection. The immediate and follow-up results were assessed.


RESULTS
Eleven stent-grafts were placed successfully in the 8 patients, the mean diameter of stents was 29.4 (22-38) mm. Three patients had a mild endoleak and 2 patients had a tiny shunt immediately after operation. Ascending aortic dissection occurred in 1 patient after balloon dilation. The mean stay in hospital was 9 days. All the eight patients were followed up and the mean time of follow-up was 10.5 (6-18) months, 4 residual shunts disappeared. No stents displacement or new endoleak occurred.


CONCLUSIONS
Transfemoral stent-graft placement in combination with TEE for the treatment of DeBakey IIIb aortic dissection is a promising method, which is safe, effective and with little injury. Its recent and middle term result is satisfactory, but further observation is needed for long term result.
Medical Emergency Center of Heart, Lung and Blood Vessel Disease, Anzher Hospital, Beijing 100029, China.
Zhi-zhong
ZZ
Li
Shang-dong
SD
Xu
Si-hong
SH
Zheng
Zhi-an
ZA
Li
Jia-hui
JH
Du
Yan-qing
YQ
Sun
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome