Effect of distal aortic TEVAR after acute type A aortic dissection surgery
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R654.2

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    Abstract:

    Objective:To investigate the safety and efficacy of thoracic endovascular aortic repair(TEVAR)in patients with stent induced new entry(SINE)in the distal aortic dilation following surgical repair of type A aortic dissection(TAAD). Methods:A retrospective analysis was performed on 27 consecutive patients who underwent TEVAR for stent graft-induced distal aortic dilation in Nanjing Medical University First Affiliated Hospital from January 2018 to March 2023. The intraoperative data of 27 patients with Sun’s surgery(total aortic arch replacement plus stented elephant trunk implantation),early postoperative follow-up results of Sun’s surgery, intraoperative data of 27 patients with TEVAR and postoperative follow-up results were statistically analyzed. Results:The follow-up rate after TEVAR was 92.3%,with a mean follow-up time of(35±21)months. There were two cases of long-term mortality,resulting in a mortality rate of 7.4%,with no deaths related to aortic complications. No stent graft leak,displacement,paraplegia,new-onset dialysis (post-TEVAR new-onset renal dysfunction),intestinal ischemia,or necrosis was observed after TEVAR. Among the follow-up cases, preoperative and postoperative computed tomographic angiography(CTA)of the thoracoabdominal vessels were successfully obtained in 25 cases(92.3%). At 6 months postoperatively,CTA revealed that the rupture was completely covered,the distal true cavity opening of the thoracic aorta was satisfactory,and the vascular patency of the internal organs and lower limbs was 100% . 19 patients were followed up 1 year after surgery. Among them,there were 13 cases(68.4%)of complete thrombolysis and 6 cases(31.6%)of partial thrombolysis,the true lumen was effectively opened,the true lumen of the stent covered area was significantly enlarged,and the false lumen was reduced. Conclusion:TEVAR treatment of distal aorta after acute type A aortic dissection is effective without significant adverse events,making it a recommended surgical approach .

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沈健,倪布清,李明辉.急性A型主动脉夹层术后主动脉远端TEVAR的效果分析[J].南京医科大学学报(自然科学版英文版),2024,(2):205-209.

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History
  • Received:September 29,2023
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  • Online: February 05,2024
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