ECHOCARDIOGRAPHY GUIDED ENDOVASCULAR GRAFT EXCLUSION FOR THE TREATMENT OF STANFORD B AORTIC DISSECTION

Objective This study was aimed to evaluate the feasibility, safety and efficacy of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) guided endovascular graft exclusion (EVGE) for the treatment of Stanford B aortic dissection. Methods In 11 patients with Stanford B aortic dissection, TEE and TTE were used to determine the parameters for pre-surgery diagnosis and selection of a coated stent. During surgery, TEE and TTE provided real-time and dynamic monitoring and guiding for precise implantation of the coated stent to effectively seal the tear of the aortic dissection. After surgery, clinical efficacy and potential side effects of the implantation of the coated stent were evaluated. Results In all 11 patients, the coated stent was successfully implanted and morphologic and hemodynamic defects were corrected. Follow-up examinations performed at 1 year post-surgery showed neither displacement nor morphologic alternation of the implanted stent. An improvement of cardiac function and blood supply was observed. There was no main ductus arteriosus perforation or hematoma, vital organ failure, paraplegia or endoleak. Conclusions In our study with a limited number of patients, TEE and TTE guided EVGE treatment of Stanford B aortic dissection was safe and efficacious with reduced risk of complications. As echocardiography is real-time, dynamic, noninvasive, reproducible, non-radioactive and contrast media damage free, TEE and TTE guided EVGE offers a novel and viable clinical approach for the treatment of Stanford B aortic dissection.