The Follow-up Of Open Placement Of Triple-Branched Stent Graft Technique In The Treatment Of Stanford Type-A Aortic Dissection

[Objective]:To evaluate the immediate and follow-up effects of the open placement of triple-branched stent graft technique in the treatment of Stanford type-A aortic dissection.[Methods]:Seventy-two patients who suffered from Stanford type-A aortic dissection during July2009to December2011received open placement of triple-branched stent graft technique. All operations were done under general anesthesia, deep hypothermic circulatory arrest and selective cerebral perfusion. The mechanical ventilation support period, duration of intensive care unit stay, and bleeding electric-beam computed tomography report and echocardiography report before discharge were recorded, All patients were contacted by telephone or direct interviews in our department for1-2years after opertion.[Results]:There was no intraoperative death. Five patients died in hospital. Causes of death are abdominal aortic aneurysms rupturing, acute renal failure(ARF), low cardiac output syndrome(LCOS), severe pneumonia(SP) and cardiac arrest. The mean cardiopulmonary bypass time was148.62±18.70minutes; aortic cross-clamp time was74.3±7.32minutes; and selective cerebral perfusion and lower-body arrest time was27.71±7.44minutes. The time for chest closure was93.58±16.33minutes. The postoperative mechanical ventilation support period was13.50-34.50h(20.67±3.36h). The duration of intensive care unitstay was42-124.5h (67.06±10.41h), Bleeding150-650ml (276.87±73.66ml). One stroke and one peripheral vascular complication.7persons suffered from ARF received continuous renal replacement therapy (CRRT),one person suffered from multiple organ failure and died in hospital, one person died three weeks after discharge and the others surrived. Postopertive transaminase or bilirubin in a high lever in13cases. There are four SPs, one of them died in hospital, other one died afer discharge, the other two were cured. The postoperative computed tomographic scans and echocar-diographic examinations showed that artificial blood vessel opened well, and there was no space or blood flow surrounding the triple-branched stent graft.61people were followed up during1-2years after operation.6lost. All The61people received echocar-diographic and computed tomographic scans examinations[Conclusion]:Open placement of triple-branched stent graft technique is an easy, safe and effective treatment of Stanford type-A aortic dissection.