Clinical Features and Long-Term Follow-up Results in Fifty Four Patients with Aortic Dissection

Background: This study aimed to evaluate the early and long-term outcomes of a single center using a frozen elephant trunk (FET) procedure for chronic type B or non-A non-B aortic dissection.Methods: From February 2009 to December 2019, 79 patients diagnosed with chronic type B or non-A non-B aortic dissection who underwent the FET procedure were included in the present study. We analyzed operation mortality and early and long-term outcomes, including complications, survival and interventions.Results: The operation mortality rate was 5.1% (4/79). Spinal cord injury occurred in 3.8% (3/79), stroke in 2.5% (2/79), and acute renal failure in 5.1% (4/79). The median follow-up time was 53 months. The overall survival rates were 96.2, 92.3, 88.0, 79.8, and 76.2% at 1/2, 1, 3, 5 and 7 years, respectively. Moreover, 79.3% of patients did not require distal aortic reintervention at 7 years. The overall survival in the subacute group was superior to that in the chronic group (P = 0.047).Conclusion: The FET technique is a safe and feasible approach for treating chronic type B and non-A non-B aortic dissection in patients who have contraindications for primary endovascular aortic repair. The technique combines the advantages of both open surgical repair and endovascular intervention, providing comparable early and long-term follow-up outcomes and freedom from reintervention.

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Type B Aortic Dissection Complicated by Intimo-Intimal Intussusception and Extensive Intimal Denuding: Case Report with Long-term Follow-up

Annals of Vascular Surgery ◽

10.1016/j.avsg.2020.06.041 ◽

2020 ◽

Vol 69 ◽

pp. 451.e5-451.e10

Author(s):

Mary Lin ◽

Alison O. Flentje ◽

Charles Drucker ◽

Siamak Dahi ◽

Aakash Shah ◽

...

Keyword(s):

Case Report ◽

Aortic Dissection ◽

Type B ◽

Type B Aortic Dissection ◽

Long Term Follow Up ◽

Intimal Intussusception

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Open stented elephant trunk for complicated Stanford type B aortic dissection: a single-center experience

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01341-6 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Hongtao Tie ◽

Lingwen Kong ◽

Zhengjie Tu ◽

Dan Chen ◽

Delai Zheng ◽

...

Keyword(s):

Length Of Stay ◽

Aortic Dissection ◽

Type B ◽

Type B Aortic Dissection ◽

Elephant Trunk ◽

Open Set ◽

Long Term Follow Up ◽

Stanford Type B

Abstract Background Open stented elephant trunk (SET) or SET with left subclavian artery (LSCA) to left common carotid artery (LCCA) bypass is proven to a potentially alternative treatment for complicated Stanford type B aortic dissection (TBAD). In the current study, we reported our experience with ten consecutive TBAD patients who underwent open SET. Methods Patients with complicated TBAD underwent open SET from May 2016 to November 2018 in our institution were included. Patients’ clinical data were obtained from the electronic medical record system, and long-term clinical outcomes were collected by telephone interviews or outpatient interviews. Results A total of ten patients with nine males and one female were included, and the average age was 47.3 (31–65) years. Increased D-dimer and fibrinogen degradation products were observed in all patients at admission, and two patients had renal insufficiency. The average postoperative mechanical ventilation time, length of stay in intensive care unit, and postoperative hospital length of stay were 46.9 (6.7–151.2) hours, 7.7 (4–17) days, and 15.7 (10–26) days. No postoperative death occurred. Acute kidney injury and other complications were observed, and they were recovered well when discharge. In long-term follow-up, computed tomography angiography indicated that aortas were completely well remodeled, and blood supply of the brachiocephalic trunks was normal without anastomotic complications. All patients lived well. Conclusion SET or SET with subclavian artery correction shows satisfactory clinical outcomes, and it could be considered as an alternative treatment. Well-designed, large-scale studies with long-term follow-up are still needed.

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