We have been implanting endovascular stent grafts (EVG) via midsternotomy for distal aortic arch surgery since February 1997. The early clinical results are evaluated.Methods: There were 11 true aneurysms (8 fusiform, 3 saccular) and one chronic type B dissection. The average age was 68yr (63-81). EVGs were PTFE-covered two-8 bend Z stents in the first eight cases and made with the same stents and ultrathin woven Dacron grafts in the last four cases.Results: Total arch replacement and aortocoronary bypass grafting were combined in one and two patients, respectively. The average retrograde cerebral perfusion time was 42±8min. The cardiopulmonary bypass time averaged 211±26min. All patients awoke early after operation (4.5±1.2h). All but one case was extubated within 24h. There was no operative mortality, but paraplegia and cerebral infarction were complicated in one case each. Their maximum diameter (73.9±21.2mm) decreased significantly after operation (68.7±20.1mm) and one year thereafter (63.1±16.0mm). True aneurysms were thrombosed completely. A chronic type B dissection revealed impending rupture due to false lumen infection one year after operation. The whole descending aorta replacement was performed but the patient died 6months thereafter due to cerebro-vascular complication.Conclusion: Implantation of EVGs reduces operative invasion for distal arch surgery. This procedure should improve mortality, while long-term results have not been clarified. Copyright (C) 2000 The International Society for Cardiovascular Surgery.
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine