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EARLY RESULTS OF HYBRID SURGICAL TREATMENT OF STANFORD TYPE B AORTIC DISSECTION
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Abstract
Background: Stanford type B aortic dissection (TBAD) is a common vascular disease with an incidence of about 3/100,000 people/year, with a 5-year mortality rate of 30-40% if not treated appropriately. Treatment of TBAD includes medical and surgical treatment, in which hybrid surgery with debranching of aortic arch combined endovascular intervention and placement of a stentgraft is increasingly applied. It is widely used in cases where the proximal lower extremity is not suitable. Objective: To evaluate the early results of hybrid surgical treatment of Stanford type B aortic dissection. Material and Methods: A retrospective and case series study of patients who underwent surgery to treat aTBAD at Cho Ray hospital from January 2017 to December 2020. Results: 43 patients diagnosed with aTBAD were indicated for hybrid surgery with the average age of 54.8± 12.3, oldest patient is 75 years old, the youngest patient is 31 years old, 67.4% of patients is male. There were 15 cases of surgery for transposition of the LCCA - LSA, 28 cases of surgery for transposition of the RCCA – LCCA - LSA. Average operative time 304,5 ± 76,37 minutes, the postoperative hospital stay is 7.91±2.93 days. The technical success was achieved in 97.6%. Paraplegia developed in 1 patient (2,3%), 1 case of transpositional hematoma(2,3%), left recurrent laryngeal nerve injury developed in 1 case(2,3%), Thirty-day mortality was 2.3% (1 of 43) due to cerebral hemorrhage, severe pneumonia. Average follow-up time is 10.6 ± 1.8 months. Follow-up mortality rate 2,4%, endoleak type IB 2,4%, retrograde type A dissection 2,4%. Conclusions: Hybrid surgery for treatment of acute TBAD with inappropriate proximal landing zone has good results, complications and mortality rate are low. Long-term results: need further evaluation.
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Keywords
Stanford type B aortic dissection, hybrid surgery
References
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