Repair of Stanford type A aortic dissection with ascending aorta and hemiarch replacement combined with stent-graft elephant trunk technique by using.

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Repair of Stanford type A aortic dissection with ascending aorta and hemiarch replacement combined with stent-graft elephant trunk technique by using innominate cannulation Enyi Shi, MD, PhD, Tianxiang Gu, MD, PhD, Lei Yu, MD, Zongyi Xiu, MD, Zhiwei Zhang, MD, PhD, Chun Wang, MD, PhD, Qin Fang, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 6, Pages 1458-1463 (December 2011) DOI: 10.1016/j.jtcvs.2011.02.027 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Diagram of innominate artery cannulation. A, For cooling and rewarming, the tip of the cannula is pointing toward the arch and the crossclamp is placed at the ascending aorta. B, For selective antegrade cerebral perfusion, the tip of the cannula is oriented toward the head and the crossclamp is placed proximal to the site of cannulation of the innominate artery. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1458-1463DOI: (10.1016/j.jtcvs.2011.02.027) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) of a patient with Stanford type A dissection before the operation (A and B) and 3 weeks after the operation (C and D). A, CTA shows the lesion of ascending aorta. B, MRA demonstrates the patent false lumen in the descending aorta clearly. C, CTA shows the vascular prosthesis of the ascending aorta and innominate artery. No evidence of stenosis of the innominate artery can be observed after cannulation; D, CTA shows that the stent graft is implanted in the distal aorta and the false lumen of the descending aorta is closed completely. E, Diagram of simplified stent-graft elephant trunk technique. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1458-1463DOI: (10.1016/j.jtcvs.2011.02.027) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Computed tomographic angiography (CTA) of a patient with Stanford type A dissection before the operation (A, B, and C) and 1 year after the operation (D, E, and F). The patent false lumen is shown at 3 levels: proximal descending aorta (A), middle of the descending aorta (B), and diaphragmatic level (C). The true lumen in the descending aorta is restored completely and the false lumen decreases significantly by stent-graft implantation, as shown at the 3 corresponding levels (C, D, and E). The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1458-1463DOI: (10.1016/j.jtcvs.2011.02.027) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions