geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch?


, : Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch?. Circulation 123(9): 971-978

Appropriate surgical management of type A dissection is a critical factor for achieving satisfactory outcome, but the choice of optimal procedure is controversial. We retrospectively reviewed our experience with aortic arch replacement for type A dissection involving the arch. Excluding 14 cases of subtotal or total aortic replacement, 411 of 544 patients with type A dissection (stented elephant trunk=291, conventional surgical repair=120) underwent aortic arch replacement between January 2003 and September 2008. In-hospital mortality was 3.09% (9 of 291) for stented (acute=4.73%, 7 of 148; chronic=1.40%, 2 of 143) and 5.00% (6 of 120) for conventional repairs (acute=6.06%, 4 of 66; chronic=3.70%, 2 of 54). Spinal cord injury was 2.41% (7 of 291) in the stented and 0.83% (1 of 120) in the conventional group. The overall prevalence of stroke was 1.95% (8 of 411) (stented=2.41%, 7 of 291; conventional=0.83, 1 of 120). Secondary intervention was 2.34% (5 of 214) for acute dissection (stented=1 and conventional=4; P=0.031) and 3.05% (6 of 197) for chronic dissection (stented=4 and conventional=2; P=0.661) during follow-up. Obliteration of the false lumen around the stented elephant trunk occurred in 94.2% (130 of 138) of patients with acute dissection and in 92.0% (126 of 137) of patients with chronic dissection. Total arch replacement combined with stented elephant trunk implantation demonstrated the superiority of the combination of the surgical and interventional approaches while avoiding the weaknesses associated with the individual methods. The encouraging surgical results could enable this procedure to become the new "standard" therapy for type A dissection involving repair of the aortic arch.

US$19.90

PMID: 21339481

DOI: 10.1161/CIRCULATIONAHA.110.015081


Other references

Jeannel, R., 1955: Trois Trichaphaenops des Alpes occidentales et du Jura. Notes Biospeologiques Paris, 10: 19-22

Ogi H., 1983: The route expressions of inhabitants of the tsukuba science city japan. Journal of Human Ergology 12(2): 208-209

Zhuang, R.; Huang; Aizhu; Dong; Ruxiang; Wang; Debin; Chen; Yongzhong; Cai; Xiaoqun; Su; Mingmei; Deng; Xiaoan; Kuang; Yuanyu, 1992: Studies on the breeding of 19 new tea-oil varieties with high yield. 40 elite clones were tested by grafting on mature trees in regional experiment. 19 new prolific varieties of Camellia oleifera, such as Yalin No.4 (Ju No.24) were selected based on data of oil production and fruit quality in four consecutive years...

Blin, O.; Desnuelle, C.; Rascol, O.; Borg, M.; Peyro-Saint-Paul, H.; Azulay, J.P.; Bille, F.; Figarella, D.; Coulom, F., 1994: Mitochondrial respiratory failure in skeletal muscle from patients with Parkinson's disease and multiple system atrophy. We studied mitochondrial respiratory chain function in skeletal muscle taken from 27 patients with idiopathic Parkinson's disease (PD; 21 Dopa-treated PD patients and 6 de novo patients), 5 patients with multiple system atrophy (MSA) and from...

Gunnarson H.J., 1967: Design and testing of a inst thermistor transducer to measure very low air velocity. Transactions Of The Asae (american Society Of Agricultural Engineers): 769-770

Warshaw, H.S.; Ackers, G.K., 1971: Molecular sieve studies of interacting protein systems. 8. Critical evaluation of the equilibrium saturation technique using stacked gel columns. Analytical Biochemistry 42(2): 405-421

Haggerty Janet A.; Premoli Silva Isabella, 1986: Ooids and shallow-water debris in Aptian-Albian sediments from the East Mariana Basin, Deep Sea Drilling Project Site 585; implications for the environment of formation of the ooids. Initial Reports of the Deep Sea Drilling Project: ages 399-412. 1986.

Abdalla, M.M.F.; Roushdi, M.; Morad, M.M., 1975: Selection of field beans, Vicia faba L. with improved seed yield and better chemical composition. Following analysis of seeds of several selections for contents of protein, starch, fat and ash, chemical composition was found not to be associated with seed size or yield, but in some cases higher yielding selections did have higher crude-protein...

Raulli, R.E.; Arendash, G.; Crews, F.T., 1989: Effects of nBM lesions on muscarinic-stimulation of phosphoinositide hydrolysis. The nucleus basalis magnocellularis (nBM) is believed to be the major path of cholinergic innervation to the frontal cortex. The cerebral cortex is known to contain muscarinic receptors that are coupled to the hydrolysis of phosphoinositides (PI)...

Broussard, A.Bienvenu.; Borazjani, J.G., 2008: The faces of Moebius syndrome: recognition and anticipatory guidance. Moebius syndrome is a rare congenital disorder characterized mainly by the inability to move the eyes laterally or produce facial expressions such as smiling. Moebius syndrome creates physical problems for the affected individual that may, in some...