title: Total arch repair for acute type A aortic dissection with open placement of a modified triple-branched stent graft and the arch open technique.
abstract: BACKGROUND
  In total arch repair with open placement of a triple-branched stent graft for acute type A aortic dissection, the diameters of the native arch vessels and the distances between 2 neighboring arch vessels did not always match the available sizes of the triple-branched stent grafts, and insertion of the triple-branched stent graft through the distal ascending aortic incision was not easy in some cases. To reduce those two problems, we modified the triple-branched stent graft and developed the arch open technique.
  
  
  RESULTS
  Total arch repair with open placement of a modified triple-branched stent graft and the arch open technique was performed in 25 consecutive patients with acute type A aortic dissection. There was 1 surgical death. Most survivors had an uneventful postoperative course. All implanted stents were in a good position and wide expansion, there was no space or blood flow surrounding the stent graft. Complete thrombus obliteration of the false lumen was found around the modified triple-branched stent graft in all survivors and at the diaphragmatic level in 20 of 24 patients.
  
  
  CONCLUSIONS
  The modified triple-branched stent graft could provide a good match with the different diameters of the native arch vessels and the various distances between 2 neighboring arch vessels, and it's placement could become much easier by the arch open technique. Consequently, placement of a modified triple-branched stent graft could be easily used in most patients with acute type A aortic dissection for effective total arch repair.
authors.affiliation: Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, China. chenliangwan@tom.com.
authors.forename: Liang-Wan
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, China. wxjusa@163.com.
authors.forename: Xi-Jie
authors.initials: XJ
authors.lastname: Wu
authors.affiliation: Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, China. 1470054258@qq.com.
authors.forename: Xiao-Fu
authors.initials: XF
authors.lastname: Dai
authors.affiliation: Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, China. 819266967@qq.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.affiliation: Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, China. liao89612@163.com.
authors.forename: Dong-Shan
authors.initials: DS
authors.lastname: Liao
authors.affiliation: Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, China. 12024280@qq.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, China. doctorlqz@163.com.
authors.forename: Qian-Zhen
authors.initials: QZ
authors.lastname: Li
mesh_terms: D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D015607:Stents; D016896:Treatment Outcome
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