title: Surgery for acute aortic dissection using the Chinese CRONUS stented elephant trunk technique: experience with 252 patients.
abstract: OBJECTIVE
  The elephant trunk method was introduced to treat aortic disease. There are a variety of modified elephant trunk methods, including the stented elephant trunk. We retrospectively reviewed our experience and evaluated the effectiveness of surgical treatment for acute aortic dissection using the Chinese CRONUS stented elephant trunk technique.
  
  
  METHODS
  From August 2005 to December 2012, 252 patients with acute aortic dissection underwent surgical treatment using the Chinese CRONUS stented elephant trunk technique at the Renmin Hospital of Wuhan University. We review the characteristics of the patients, the surgical method, and the prognosis. Furthermore, we modified the stented elephant trunk technique to simplify the surgical procedure using stented elephant trunk fenestration in 81 patients.
  
  
  RESULTS
  The procedure was technically successful in all patients. The mean duration of cardiopulmonary bypass, myocardial ischemia, and circulatory arrest was 158±34 minutes, 98±24 minutes, and 27±9 minutes, respectively. The mean stay in the intensive care unit was 74±11 hours. The in-hospital mortality rate was 3.2% (8/252). A 92.2% (225/244) follow-up rate was achieved. Five patients died during follow-up. The diameter of the descending aorta significantly decreased in 173 patients (78.6%), did not change 39 patients (17.7%), and dilated in 8 patients (3.7%).
  
  
  CONCLUSIONS
  In surgery for acute aortic dissection, the Chinese CRONUS stented elephant trunk technique had a low prevalence of morbidity and mortality in our patients. The satisfactory effects demonstrated that the technique is safe and effective in closing the residual false lumen of the descending aorta. Stented elephant trunk fenestration could further simplify the surgical procedure with minimal invasion.
authors: Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, People's Republic of China.
authors: Hong-bing
authors: HB
authors: Wu
authors: Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, People's Republic of China.
authors: Hao
authors: H
authors: Zhang
authors: Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, People's Republic of China. Electronic address: hbwu2008@163.com.
authors: Zhi-wei
authors: ZW
authors: Wang
authors: Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, People's Republic of China.
authors: Rui
authors: R
authors: Hu
authors: Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, People's Republic of China.
authors: Luo-cheng
authors: LC
authors: Li
authors: Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, People's Republic of China.
authors: Min
authors: M
authors: Zhang
authors: Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, People's Republic of China.
authors: Xiao-ping
authors: XP
authors: Hu
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D002315:Cardiopulmonary Bypass; D002681:China; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D005260:Female; D006323:Heart Arrest; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome