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Ann Thorac Surg 2002;73:1138-1141
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Self-expandable aortic stent-grafts for treatment of descending aortic dissections

J. Honório Palma, MD*a, Jose Augusto Marcondes de Souza, MDa, Claudia Maria Rodrigues Alves, MDa, Antonio Carlos Carvalho, MDa, Enio Buffolo, MDa

a Cardiovascular Surgery and Cardiology Discipline, Medical School, São Paulo Federal University, São Paulo, Brazil

Accepted for publication December 21, 2001.

* Address reprint requests to Dr Palma, Cardiovascular Surgery Department, São Paulo Federal University, Rua Borges Lagoa 1080, 7o Andar, São Paulo, S.P., Brazil, CEP 04038-002
e-mail: jhpalma.dcir{at}epm.br

Background. Acute aortic dissection is a life-threatening medical condition that is associated with high morbidity and mortality.

Methods. Of 198 patients treated with a self-expanding polyester-covered stent-graft for various pathologic aortic conditions in our institution, we selected 70 consecutive patients with type B aortic dissection who were undergoing treatment. The stent-graft was introduced through the femoral artery in the angiography suite, under general anesthesia with systemic heparinization and induced hypotension.

Results. The procedure was performed in 70 patients; of these, 58 had descending aortic dissection and 12 had atypical dissections. The procedure was successful in 65 patients (92.9%), as documented by exclusion of the false lumen of the thoracic aorta. Eleven patients (18.9%) had persistent blood flow in the false lumen of the abdominal aorta due to distal reentries. Five patients (7.1%) underwent conversion to surgery. Insertion of additional stent-grafts was required in 34 patients (48.6%). At 29 months of follow-up, 91.4% of the patients were alive.

Conclusions. Stent-grafts are an important means of treating aortic dissections, which may replace conventional medical treatment of this condition for the majority of patients.


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