[Clinical application of total or subtotal aortic replacement on the one stage].
OBJECTIVE
To summarize the experience of the application of total and subtotal aortic replacement on the one stage in the treatment of the patients with extensive aortic aneurysm and chronic Stanford type A dissecting aneurysm.


METHODS
From February to November 2004, 8 patients (7 male and 1 female; ranging from 23 to 47 years old) underwent one-stage total or subtotal aortic replacement under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion. Two patients received subtotal aortic replacement (from the aortic valve to the abdominal aorta). Six patients underwent total aortic replacement (from the aortic valve to the aortic bifurcation), of which 3 patients had aortic valve replacement. Patients were with mid-sternotomy and thoracoabdominal incision. The ascending aorta was firstly replaced, following which the aortic arch was reconstructed. Finally, the thoracoabdominal aorta was fully replaced.


RESULTS
There was no operative or early postoperative death. One patient had cerebral infarction secondary to embolism. Spinal neurological deficits didn't occur. All 8 patients were alive and had good functional status 2 to 12 months after operation.


CONCLUSIONS
The patients performed with one-stage total and subtotal aortic replacement achieves good results. It can eliminate the risk of remnant aneurysm rupture in staged total aortic replacement.
Sun
Li-zhong
LZ
Aortic Surgery Center, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Chang
Qian
Q
Hu
Xiao-peng
XP
Zhu
Jun-ming
JM
Yu
Cun-tao
CT
Liu
Zhi-gang
ZG
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome