关键词: 主动脉夹层, 象鼻技术, 马凡氏综合征

Abstract:

To evaluate the effect of a surgical approach for aortic dissection with a stented elephant trunk. MethodsBetween July 2003 and December 2007, a total of 94 patients, 80 males and 14 female with aortic dissection underwent surgical repairs with a modified stented elephant trunk technique and total arch replacement． The sinus of the valsalva was reconstructed in 8 patients, aortic valve replacement was used in 18 patients, and ascending aorta replacement was performed in 81 patients. ResultsAverage extracorporeal circulation time was (187.09±44.08) min, the aortic crossclamp time was (99.70±27.51) min， the selected cerebral perfusion time was (22.47±11.35) min and the lower body arrest time was (20.87±8.86)min. Hospital mortality was 2.13％(2／94). Mean time of followup was (34.86±18.08) months and the survival rate was 96.63%. Only one patient required reoperation for distal descending aorta replacement because of continuous false lumen extension. It accounted for 50% that diameter proportion between the stented graft and the aortic lumen at least one year postsurgery achieved more than 90%. ConclusionThe modified stented elephant trunk anastomosis technique is an effective way for closing the residual false lumen of the descending aorta and may contribute to better longterm outcomes for aortic dissection.

Key words: ortic dissection; Elephant trunk technique; Marfan