Ten Years' Experience of Surgical Treatment with Modified Triple-Branched Stent Graft for Type A Aortic Dissection.

Abstract

Background: In the past decade, modified triple-branched stent grafts have emerged as a promising treatment option for total aortic arch replacement surgery for type A aortic dissection (TAAD). In this study, we present our original contributions and clinical experiences with this surgical technique over the last 10 years.

Methods: We retrospectively analyzed patients who underwent total aortic arch replacement surgery for TAAD using modified triple-branched stent grafts between September 2012 and September 2022, collecting and analyzing all related data.

Results: In total, 479 patients with a mean age of 53 years and a male predominance of 60.5% were enrolled. The thirty-day mortality was 4.8% (23/479 patients). Early postoperative complications were observed in 42 (8.8%) patients. An average follow-up period of 72 months resulted in a survival rate of 83.1% (353/425); 31 patients were lost to follow-up (6.8%). The false aortic lumen thrombosis rate was 79.3%. Stent-related complications occurred in 34 cases, with 3 of these cases consequently requiring reoperation. However, stent-related complications did not affect mortality or morbidity during follow-up. Of the patients, 46 (10.8%) had negative remodeling of aortic dissection, 20 underwent surgery because of a dissecting aneurysm, and 8 died of aortic rupture.

Conclusions: Our 10-year experience with modified triple-branched stent grafts for the surgical treatment of TAAD demonstrated the promising results of this technique, indicating that it provides a feasible and convenient alternative to traditional surgical methods, with clear long-term effectiveness and safety.