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The Journal of Cardiovascular Surgery 2002 October;43(5):655-6

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Significance of distal fenestration in graft replacement for chronic aortic dissection

Fukada J. 1, Morishita K. 1, Naraoka S. 1, Kawaharada N. 1, Tabata A. 1, Hyodoh H. 2, Abe T. 1

1 Cardiothoracic Surgery 2 Radiology Sapporo Medical University School of Medicine Sapporo, Japan


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It is recent­ly con­tro­ver­sial wheth­er dis­tal fen­es­tra­tion is nec­es­sary in ­graft replace­ment for chron­ic aor­tic dis­sec­tion. Several ­groups start­ed to try the exclu­sion of inti­mal ­entry by the inser­tion of a ­stent-­graft as a treat­ment for chron­ic aor­tic dis­sec­tion, ­while con­ven­tion­al sur­gi­cal tech­niques con­sist­ed of ­graft replace­ment ­with dis­tal anas­tom­o­sis to ­both the ­true and ­false chan­nels. It ­should be ­kept in ­mind ­that the resul­tant occlu­sion of the ­false ­lumen ­after oblit­er­a­tion of the ­false chan­nel ­could pro­mote spi­nal ­cord ische­mia. We ­report a ­patient ­with ­delayed par­a­ple­gia ­after ­graft replace­ment with­out dis­tal fen­es­tra­tion for chron­ic ­type B aor­tic dis­sec­tion. It is pos­sible ­that not all cas­es of chron­ic aor­tic dis­sec­tion are ­good for ­stent-graft­ing.

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