title: One-stage repair for stanford type B aortic dissection concomitant with cardiac diseases: open stented elephant trunk technique combined with cardiac operation.
abstract: BACKGROUND
  We evaluated an open stented elephant trunk (sET) technique combined with cardiac operations for a one-stage treatment of patients with complicated Stanford type B aortic dissection (AoD) and cardiac diseases.
  
  
  METHODS
  Between April 2007 and March 2010, 16 patients with Stanford B AoD and cardiac diseases (mean age 49.75 ± 13.42 years) underwent sET combined with cardiac operations. Under deep hypothermic cardiac arrest (DHCA), a stented graft was directly delivered via the incision of aortic arch and the proximal graft was sutured on the normal distal aortic arch wall in a continuous circumferential full-thickness fashion. The combined cardiac operations (Bentall procedure, etc.) were performed before sET implantation while cooling.
  
  
  RESULTS
  Average time of cardiopulmonary bypass, aortic cross clamping durance, and DHCA was 131.62 ± 23.85, 64.69 ± 9.72, and 21.94 ± 3.60 minutes, respectively. There were no early deaths and no neurological complications. During a follow-up of 18.69 ± 9.94 months, computed tomographic angiography was performed in all patients. Neither endoleak nor stent shifting was observed. Retrograde type A AoD was not found during follow-up. Thrombus was formed in the false lumen from the proximal descending aorta to the diaphragmatic section.
  
  
  CONCLUSIONS
  The open sET technique combined cardiac procedures can reliably treat Stanford type B AoD concomitant with surgical cardiac disease in a single stage.
authors.affiliation: Department of Cardiovascular Surgery, Beijing Anzhen Hospital of Capital Medical University, Beijing Aortic Disease Centre, Chaoyang District Beijing, China.
authors.forename: Junming
authors.initials: J
authors.lastname: Zhu
authors.forename: Lijian
authors.initials: L
authors.lastname: Cheng
authors.forename: Yongmin
authors.initials: Y
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Zheng
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Qiao
authors.forename: Chengnan
authors.initials: C
authors.lastname: Li
authors.forename: Lizhong
authors.initials: L
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass; D002681:China; D050792:Circulatory Arrest, Deep Hypothermia Induced; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome