Surgical treatment for type Stanford A aortic dissection with Kommerell′s diverticulum
Li Jianrong, Ma Weiguo, Zheng Jun, Liu Yongmin, Xu Shangdong, Li Yu, Zhu Junming, Sun Lizhong
Abstract
ObjectiveTo examine the outcomes of surgical treatment in patients of type Stanford A aortic dissection with Kommerell′s diverticulum.
MethodsFrom January 2009 to August 2017, patients of type Stanford A aortic dissection with Kommerell′s diverticulum who underwent the Sun procedure were enrolled. Patient demographic, preoperative, intraoperative, early morbidity and mortality data were collected from medical and electronic patient records. Clinical follow-up data, including late morbidity and mortality, were obtained by telephone interview with the patient.
ResultsA total of 13 patients (11 males and 2 females; mean age 47 years) were included. The mean maximum diameter of Kommerell′s diverticulum was (21.8±7.7) mm. The Kommerell′s diverticulum was repaired by direct suture of the orifice in 3 patients, ligation of the aberrant right subclavian artery in 9 patients, and suture and ligation in 1 patient, respectively. No perioperative death occurred. One patient underwent a reexploration for bleeding. There were 2 late deaths: unknown reason in 1 patient and septic shock secondary to renal abscess in 1 patient. Reintervention was performed in one patient for a persistent type Ⅱ endoleak.
ConclusionsThe Sun procedure with femoral artery cannulation for cardiopulmonary bypass, unilateral carotid artery cannulation for selective cerebral perfusion and ligation of aberrant right subclavian artery on the right side of the trachea is an appropriate therapeutic strategy for patients of type Stanford A aortic dissection with Kommerell′s diverticulum.
Key words:
Aneurysm,dissecting; Aorta,thoracic; Kommerell′s diverticulum
Contributor Information
Li Jianrong
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China
Ma Weiguo
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China
Zheng Jun
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China
Liu Yongmin
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China
Xu Shangdong
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China
Li Yu
Department of Medical Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Zhu Junming
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China
Sun Lizhong
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China
