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Surgery for acute type A dissection using total arch replacement combined with stented elephant trunk implantation: Preservation of autologous brachiocephalic.

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Presentation on theme: "Surgery for acute type A dissection using total arch replacement combined with stented elephant trunk implantation: Preservation of autologous brachiocephalic."— Presentation transcript:

1 Surgery for acute type A dissection using total arch replacement combined with stented elephant trunk implantation: Preservation of autologous brachiocephalic vessels  Jun-Ming Zhu, MD, Rui-Dong Qi, MD, Lei Chen, MD, Wei Liu, MD, Cheng-Nan Li, MD, Zhan-Ming Fan, MD, Li-Zhong Sun, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 150, Issue 1, Pages (July 2015) DOI: /j.jtcvs Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Technique of total arch replacement combined with stented elephant trunk, using preservation of autologous brachiocephalic vessels (see text for details). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 View of the neoaortic arch from the inside, the greater curvature side and the anterior. H, Implantation of the remaining aortic arch wall containing the IA and LCCA into the stent-free sewing edge (detailed description of Figure 1, H). Ha, Inside view of the neoaortic arch. The site of the first stitch is indicated by the black circle. One end of the suture was run counterclockwise within the aortic arch. Hb, The neoaortic arch seen from the greater curvature side. The first stitch is shown by the black circle. The other end of the 4-0 Prolene (polypropylene; Ethicon, Inc, Somerville, NJ) suture was run clockwise outside the aortic arch. Hc, The neoaortic arch from an anterior view; the remaining aortic arch wall and the trimmed stent-free sewing edge commonly form a distal rounded opening. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Three-dimensional computed tomography reconstruction of acute type A dissection using total arch replacement, combined with stented elephant trunk implantation, with preservation of autologous brachiocephalic vessels, 2 years after surgery. A, The patency of the anastomotic site between the LSCA and the LCCA. B, The descending thoracic aorta and upper abdominal aorta restored to normal after remodeling. C, The presence of the false lumen in the abdominal aorta below the left renal artery level. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

5 View of the neoaortic arch from the inside, the greater curvature side and the anterior.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

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