A combined branched stent grafting technique to reconstruct total aortic arch in the treatment of stanford A aortic dissection.

Traditional total arch replacement technology and artificial blood vessels are designed for patients with Stanford A aortic dissection who have 3 branches (brachiocephalic trunk, left common carotid artery, and left subclavian artery) arising from the arch of the aorta. However, if there is anatomical variation of the aortic arch branches, the operation will be very difficult. The number of primary branches of the aortic arch can be reduced to 1 or 2 or increased to 4 to 6. Also, anastomoses of the graft to the left subclavian artery and descending aorta are usually very difficult because of the deep surgical field. Moreover, once bleeding occurs after the anastomoses, hemostasis in the deep field is difficult. Therefore, we applied a "combined branched" stent grafting technique for total arch reconstruction to reduce such problems. (C) 2013 by The Society of Thoracic Surgeons