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Results of "elephant trunk" total aortic arch replacement using a multi-branched, collared graft prosthesis.
Schneider, Stefan R B; Dell'Aquila, Angelo M; Akil, Ali; Schlarb, Dominik; Panuccio, Guiseppe; Martens, Sven; Rukosujew, Andreas.
Afiliación
  • Schneider SR; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany. stefan.schneider@ukmuenster.de.
  • Dell'Aquila AM; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
  • Akil A; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
  • Schlarb D; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
  • Panuccio G; Department of Vascular and Endovascular Surgery, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
  • Martens S; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
  • Rukosujew A; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
Heart Vessels ; 31(3): 390-6, 2016 Mar.
Article en En | MEDLINE | ID: mdl-25491933
We report on our experience with a simplified elephant trunk (ET) procedure with a multi-branched prosthesis (Vascutek(®) Siena™ Collared Graft). It consists of a proximal portion (20 cm) with prefabricated side branches, a collar and a distal portion (30 cm). The collar, which can be trimmed into any desired diameter, constitutes the suture portion to the descending aorta. Radiopaque markers in the distal portion indicate the landing zone. Between January 2011 and June 2013, 20 consecutive patients (10 women; mean age, 66 ± 9.3 years) underwent ET procedure, including 6 re-do cases. Underlying aortic diseases were acute dissection (n = 6), chronic dissection (n = 4), aneurysm (n = 8) and PAU (n = 2). Mean preoperative diameter of the descending aorta was 49.1 ± 12.9 mm (range 74.7-29.7 mm). Concomitant procedures included ascending aortic replacement in 16 patients; root replacement in 2; AVR in 2, CABG in 3 and mitral repair in 1 patient. CPB time was 263 ± 94 min; mean duration of ACP was 65 ± 14 min. Two patients died on POD 8 and 78, respectively. Major adverse events included stroke (n = 1), resternotomy for bleeding (n = 2), renal failure requiring temporary dialysis (n = 1) and recurrent nerve paresis (n = 2). After a mean follow-up of 10 ± 8 months, all discharged patients were alive. Seven patients underwent stent-graft implantation of the descending aorta and one patient underwent open descending aortic replacement. The last generation of multi-branched arch prosthesis and especially the Vascutek(®) Siena™ Collared Graft make ET procedure a reasonable treatment option even in patients with acute aortic dissection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aorta Torácica / Aneurisma de la Aorta / Prótesis Vascular / Implantación de Prótesis Vascular / Disección Aórtica Tipo de estudio: Etiology_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Heart Vessels Asunto de la revista: CARDIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aorta Torácica / Aneurisma de la Aorta / Prótesis Vascular / Implantación de Prótesis Vascular / Disección Aórtica Tipo de estudio: Etiology_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Heart Vessels Asunto de la revista: CARDIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Japón