title: Open triple-branched stent graft placement for the surgical treatment of acute aortic arch dissection.
abstract: BACKGROUND
  The primary experience of open triple-branched stent graft placement for acute aortic arch dissection was reported.
  
  
  METHODS
  Between January 2011 and October 2011, 13 well-selected patients (mea age, 46±8.2 years; approximate range, 30~58 years) with acute aortic arch dissection underwent open triple-branched stent graft placement for total arch reconstruction. The triple-branched stent graft was a branched 1-piece graft consisting of a self-expandable nitinol stent and polyester vascular graft fabric (Yuhengjia Sci Tech Corp Ltd, Beijing, China). During hypothermic circulatory arrest, through the transverse incision of the ascending aorta, the main graft of the triple-branched stent graft was inserted into the true lumen of the arch and proximal descending aorta, and then each sidearm graft was positioned one by one into the aortic branch. Once the main graft and sidearm grafts were properly positioned, the restraining strings were withdrawn and then the main graft and sidearm grafts were deployed. Enhanced electric beam computed tomography was performed in each patient before discharge to evaluate the postoperative time course of the residual false lumen.
  
  
  RESULTS
  Open triple-branched stent graft placement was technically successful in all patients. The mean cardiopulmonary bypass time, aortic cross-clamp time and arrest time were 138.40±47.75 min, 70.60±28.94 min and 28.60±12.48 min, respectively. All patients were discharged from hospital. Their computed tomographic scans postoperatively showed that all stent grafts were fully opened and not kinked, there was no blood flow surrounding the triple-branched stent graft.
  
  
  CONCLUSIONS
  Open triple-branched stent graft placement is a new effective technique for total arch reconstruction in acute arch dissection.
authors.affiliation: Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. xinzangwaike@hotmail.com
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Sun
authors.forename: Shuyang
authors.initials: S
authors.lastname: Lu
authors.forename: Shouguo
authors.initials: S
authors.lastname: Yang
authors.forename: Hao
authors.initials: H
authors.lastname: Lai
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.forename: Tao
authors.initials: T
authors.lastname: Hong
authors.forename: Chunsheng
authors.initials: C
authors.lastname: Wang
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006323:Heart Arrest; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents