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

Abstract

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. In this study, we present our original contributions and clinical experiences with this surgical technique over the last 10 years. We retrospectively analyzed patients who underwent total aortic arch replacement surgery for type A aortic dissection using modified triple-branched stent grafts between September 2012 and September 2022, collecting and analyzing all related data. In total, 479 patients with a mean age of 53 years and a male predominance of 60.5% were enrolled. The 30-day mortality was 4.8% (23 of 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 of 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. Our 10-year experience with modified triple-branched stent grafts for the surgical treatment of type A aortic dissection 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.