PHẪU THUẬT THAY TOÀN BỘ QUAI ĐỘNG MẠCH CHỦ BẰNG DỤNG CỤ THORAFLEX TRONG ĐIỀU TRỊ LÓC ĐỘNG MẠCH CHỦ

Abstract

Objective: To evaluate the clinical characteristics, imaging diagnostics, and surgical outcomes of total aortic arch replacement using Thoraflex devices for the treatment of aortic dissection at Chợ Rẫy Hospital. Methods: A retrospective case series. Results: From September 2021 to June 2025, 44 patients with aortic dissection underwent aortic arch replacement using Thoraflex devices. 72,7% Stanford type A and 27,3% Stanford type B aortic dissection. Concomitant procedures included 6,8% with Tirone David operation and 6,8% with CABG. The average aortic cross-clamp time was 121.8 ± 40.03 minutes, Circulation arrest time was 42.51 ± 12.62 minutes, and operative time was 6.1 hours. Postoperative complications included new stroke (4,5%), spinal cord injury (6,8%), renal failure requiring dialysis (11,4%), and mortality (4,5%). The distal end of the stent graft was positioned at or above T8 in 93,2%, with complete thrombosis in segment A (97,7%), partial thrombosis in segment B (72.7%), and no thrombosis in segment C (86.4%). Postoperative aortic remodeling was positively confirmed in 100% of CT scans. Conclusion: Total aortic arch replacement using Thoraflex devices for treating aortic dissection at Chợ Rẫy Hospital demonstrates safety with a 4,5% mortality rate and effectiveness with 100% positive aortic remodeling post-surgery.