Supra-aortic debranching as a preliminary surgery prior to aortic endografting in patients with type B aortic dissection: immediate-term and short-term outcomes

Nasser, Mahmoud M.; Nassif, Beshoy S.; Eldessoki, Mohamed H.; Elsamadoni, Ayman; Balboula, Ahmed M.

doi:10.4103/ejs.ejs_41_23

Supra-aortic debranching as a preliminary surgery prior to aortic endografting in patients with type B aortic dissection: immediate-term and short-term outcomes

Authors

Abstract

Background
Hybrid techniques have been mainly planned for the management of complex aortic lesions to deal with the critical arch and renovisceral branches. The debranching of these aortic segments offers new landing zones suitable for endograft. The current work aims to investigate the immediate-term and short-term outcomes of supra-aortic debranching through hybrid repair in patients with type B aortic dissection.
Patients and methods
This is a retrospective study that included patients with type B aortic dissection, in whom an effective proximal seal zone necessitates coverage of one or more supra-aortic branch vessels. The patients underwent supra-aortic debranching through open surgery, after which endovascular repair was performed. Patients were followed up at 1 and 6 months.
Results
The study included 40 patients. Initial technical success was achieved for all patients. No cases of endoleaks were encountered. Two cases had postoperative strokes due to intracerebral hemorrhage. Overall, the mortality rate was 7.5%. Primary patency was maintained in 37/40 (92.5%) cases.
Conclusion
Hybrid repair was shown to be feasible for the management of patients with Stanford B dissection who required supra-aortic debranching, and could alternate with conventional aortic arch surgery. Stroke is still an issue of concern that should elicit more efforts to prevent it.

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