Hybrid reconstructive interventions in distal aortic dissection

Belov Yu.V., Charchyan E.R., Soborov M.A.
Department of Surgery of the Aorta and its Branches Russian Scientific Centre of Surgery named after Academician BV Petrovsky under the Russian Academy of Medical Sciences, Moscow, Russia

The authors report herein the findings of a prospective study including a total of 26 patients presenting with distal aortic dissection and treated by prosthetic repair of the descending portion of the thoracic aorta. The patients were subdivided into two groups, with Group One comprising 15 patients having the blood flow directed into the true channel and Group Two composed of eleven patients subjected to directing blood flow into the both channels. Twelve (80%) Group One patients were found to have thrombosis of the false channel and an increase in the true channel’s diameter. Five (45%) Group Two patients in the remote period developed dilatation of the abdominal aorta requiring distal prosthetic repair in three of them. A further two patients intraoperatively received uncoated stent grafts (Djumbodies Dissection System, Saint Come Chirurgie, France) inserted into the distal portion of the thoracoabdominal aorta in order to provide adequate perfusion of the visceral branches. It was shown that local prosthetic repair of the descending thoracic aorta is appropriate only in case of the blood flow directed into the true lumen and expansion of the compressed true channel of the aorta distal to the reconstruction site by means of stenting resulted in better haemodynamic outcomes.

KEY WORDS: distal aortic dissection, hybrid interventions, uncoated aortic stent graft.

P. 107

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