[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.
Li
Zhi-zhong
ZZ
Medical Emergency Center of Heart, Lung and Blood Vessel Disease, Anzher Hospital, Beijing 100029, China.
Xu
Shang-dong
SD
Zheng
Si-hong
SH
Li
Zhi-an
ZA
Du
Jia-hui
JH
Sun
Yan-qing
YQ
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