Left Subclavian Artery Fenestration: A Novel Treatment Strategy for Acute Type A Aortic Dissection

The Annals of Thoracic Surgery
Yangfeng TangZhiyun Xu

Abstract

The optimal surgical strategy for the left subclavian artery (LSA) during total arch replacement combined with stented elephant trunk implantation for acute type A aortic dissection remains a challenge. The objective of the study is to report a novel surgical technique aiming to simplify the revascularization procedure of total aortic arch replacement combined with stented elephant trunk implantation. We retrospectively reviewed the result of 167 patients who underwent total aortic arch replacement combined with stented elephant trunk implantation between January 2000 and December 2012. Of the 167 patients, 51 were selected to undergo the simplified revascularization, which is to fenestrate a stent graft of the descending aorta instead of performing reconstruction of the LSA. Before performing the new LSA revascularization, we had performed the elephant trunk procedure whereby the tubular material completely covered the LSA. The ensuing revascularization was modified by removing a patch of the polyester fabric of the elephant trunk that was located at the origin of the LSA. Both perioperative variables and postoperative outcome of the surgery were assessed. The indication for adopting the LSA fenestration was under the circumst...Continue Reading

References

Sep 17, 2003·Journal of Cardiac Surgery·Kurt TiesenhausenMichael Hessinger
Apr 4, 2006·The Journal of Thoracic and Cardiovascular Surgery·Nikola Dobrilovic, John A Elefteriades
Apr 27, 2010·The Annals of Thoracic Surgery·Liang-Wan ChenQi-Min Wang
Sep 18, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Syed M RehmanThanos Athanasiou
Feb 25, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A H SepehripourT Athanasiou
Mar 8, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ernst WeigangMartin Grabenwoger
Jan 10, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Kangjun ShenXinmin Zhou
Mar 26, 2013·The Journal of Thoracic and Cardiovascular Surgery·Zhenghua XiaoEryong Zhang

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Citations

Feb 6, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Jinbao QinXinwu Lu

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