title: Recent outcomes of surgery for chronic type B aortic dissection.
abstract: OBJECTIVE
  Chronic type B dissection though optimal is still considered to be a controversial procedure, even in the advent of stent grafts. Recently, we used a novel surgical technique involving left axillary perfusion to analyze the results of our surgical strategy and compare them with those reported in the literature.
  
  
  METHODS
  Between August 2004 and July 2009, 39 patients underwent graft replacement for chronic type B aortic dissection. The left axillary artery was used for perfusion inflow. Perfusion was maintained at approximately 23˚C during open proximal anastomosis. The graft was anastomosed to the distal true lumen whenever possible.
  
  
  RESULTS
  Open proximal anastomosis was performed in 22 patients (56%). In 24 cases (62%), grafts were anastomosed to the true lumen of the peripheral aorta. The early overall mortality rate was 3% (1 patient). Permanent cerebral infarction occurred in 2 patients (5%); and paraparesis, in 1 patient (3%). The Kaplan-Meier survival estimates were 91% at 2 years and 88% at 5 years.
  
  
  CONCLUSIONS
  Our surgical strategy is associated with excellent short-term and midterm outcomes. Although further investigation is needed, this strategy may be useful for patients with chronic type B dissection.
authors.affiliation: Department of Cardiovascular Surgery, Fujita Health University, Aichi, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Motomi
authors.initials: M
authors.lastname: Ando
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Higuchi
authors.forename: Kiyotoshi
authors.initials: K
authors.lastname: Akita
authors.forename: Masato
authors.initials: M
authors.lastname: Tochii
authors.forename: Michiko
authors.initials: M
authors.lastname: Ishida
authors.forename: Kan
authors.initials: K
authors.lastname: Kaneko
authors.forename: Ryo
authors.initials: R
authors.lastname: Hoshino
authors.forename: Masato
authors.initials: M
authors.lastname: Sato
keywords: aortic dissection; aortic operation; cerebral protection; partial cardiopulmonary bypass
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