title: [Brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for Stanford type A aortic dissection: analysis of 23 cases].
abstract: OBJECTIVE
  To assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection.
  
  
  METHODS
  Twenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection.
  
  
  RESULTS
  There was no perioperative death in these cases. The mean extracorporeal circulation time was 209∓52 min, the aortic cross clamp time was 85∓21 min, and the mean chest tube output within the first 24 h after the operation was 570∓263 mL; none of the patients required chest reopening for management of bleeding. Postoperative acute renal failure requiring hemodialysis occurred in 3 cases, transient neurologic dysfunction in 2 cases, paraplegia in case and hematosepsis in 1 case. No such complications as permanent neurologic deficit or postoperative visceral malperfusion occurred in these cases. All the patients survived and were discharged from hospital without experiencing severe complications in the follow-up for 6-18 months.
  
  
  CONCLUSIONS
  Brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique is a safe and simple procedure with controllable bleeding and can serve as an optional procedure for aortic arch replacement.
authors.affiliation: Department of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail: doctordusonglin@163.com.
authors.forename: Song-Lin
authors.initials: SL
authors.lastname: DU
authors.forename: Jun
authors.initials: J
authors.lastname: Wan
authors.forename: Wu-Jun
authors.initials: WJ
authors.lastname: Wang
authors.forename: Kai-Can
authors.initials: KC
authors.lastname: Cai
authors.forename: Ya-Xiang
authors.initials: YX
authors.lastname: Liu
authors.forename: Xiang-Hui
authors.initials: XH
authors.lastname: Mao
mesh_terms: D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D016122:Brachiocephalic Trunk; D005112:Extracorporeal Circulation / Q000706:statistics & numerical data; D006801:Humans; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome