Hybrid approach in surgery of proximal-type aortic dissection

Chernyavsky A.M., Lyashenko M.M., Alsov S.A., Sirota D.A., Khvan D.S.

Centre for Surgery of the Aorta, Coronary and Peripheral Arteries, Novosibirsk Scientific Research Institute for Circulatory Pathology named after Academician E.N. Meshalkin, Novosibirsk, Russia

From May 2011 to November 2012, specialists of the Novosibirsk Scientific Research Institute for Circulatory Pathology named after Academician E.N. Meshalkin carried out a total of eleven hybrid operations of prosthetic repair of the aortic ascending portion with stenting of the aortic arch and descending aortic portion using uncovered bare metal stent with open meshes «DJUMBODIS». In order to assess the false-lumen status at the level of the installed stent, all patients were subjected to contrast-enhanced MSCT before discharge from hospital and 3–11 months after surgical treatment. The obtained findings revealed thrombosis of the false channel of the dissected aorta in 5 (62.5%) out of 8 patients 3-11 (mean 10.3±4.4) months after the intervention. A hybrid approach to surgery of DeBakey type I aortic dissection is safe for patients and does not considerably complicate surgical intervention as compared with the traditional technique. Using the hybrid approach creates prerequisites for thrombosis of the aortic false lumen, which in its turn slows down dilatation of the thoracoabdominal portion.

KEY WORDS: aortic dissection, hybrid approach, thoracoabdominal aortic aneurysm.

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