Abstract
Objective
Our purpose was to examine the use of fully supported open stent grafting (OSG) with a Matsui-Kitamura (MK) stent for treatment of distal arch aneurysm (DAA).
Methods
Surgery was performed using a newly developed device in seven DAA patients (six men and one woman) from 58 to 86 years of age (mean, 73 years old) from August 2005 to June 2007. The aorta was transected at the arch between bracheocephalic artery and left subclavian artery under circulatory arrest with total cardiopulmonary bypass and selective cerebral perfusion; then the stent grafting (SG) system was inserted and positioned with a 14 Fr. pusher. The SG and a transected edge were then sutured and anastomosed with the arch graft. The surgery was completed by constructing three cerebral branches.
Results
The mean SG diameter and length were 34.6 mm (range, 32–38 mm) and 150 mm (120–200 mm), respectively. The mean time of circulatory arrest time and surgery were 41 min (35–55 min) and 358 min (269–450 min), respectively. Simultaneous mitral valve replacement was performed in one patient. All surgeries were completed successfully, and complete thrombosis of the aneurysm was obtained. Paraparesis and respiratory failure occurred in one patient each, and one patient died of brainstem infarction 1 month after surgery.
Conclusion
These initial results suggest that the OSG method is a useful surgical procedure for the treatment of DAA.
Similar content being viewed by others
References
Coselli JS, Buket S, Djukanovic B. Aortic arch operation: current treatment and results. Ann Thorac Surg 1995;59:19–26.
Borst HG, Buhner B, Jurmann M. Tactics and techniques of aortic arch replacement. J Cardiovasc Surg 1994;9:538–547.
Kato M, Ohnishi K, Kaneko M, Ueda T, Kishi D, Mizushima T, et al. New graft-implanting method for thoracic aortic aneurysm or dissection with a stented graft. Circulation 1996;94(suppl II):II-188–II-193.
Kato M, Kuratani T, Kaneko M, Kyo S, Ohnishi K. The results of total arch graft implantation with open stent-graft placement for type A aortic dissection. J Thorac Cardiovasc Surg 2002;124:531–540.
Moriyama Y, Iguro Y, Yotsumoto G, Watanabe S, Yamamoto H. Endovascular stent-graft repair with a flexible stent-graft and a simple application or prepared from a syringe. J Thorac Cardiovasc Surg 2000;119:620–621.
Miyamoto S, Hadama T, Anai H, Sako H, Iwata E, Hamamoto H. An easy, safe, and sure way of open stent grafting: chain-stitch bonding with a balloon catheter. Surg Today 2002;32:568–570.
Usui A, Fujimoto K, Ishiguchi T, Yoshikawa M, Akita T, Ueda Y. Cerebrospinal dysfunction after endovascular stent-grafting via a median sternotomy: the frozen elephant trunk procedure. Ann Thorac Surg 2002;74:S1821–S1824.
Miyari T, Kotsuka Y, Ezure M, Ono M, Morita T, Kubota H, et al. Open stent-grafting for aortic arch aneurysm is associated with increased risk of paraplegia. Ann Thorac Surg 2002;74:83–89.
Uchida N, Ishihara H, Sakashita M, Kanou M, Sumiyoshi T. Repair of the thoracic aorta by transaortic stent grafting (open stenting). Ann Thorac Surg 2002;73:444–449.
Mizuno T, Toyama M, Tabuchi N, Sunamori M. Transaortic stented graft implantation for aortic arch aneurysm. Its benefits and risk. Jpn J Thorac Cardiovasc Surg 2003;51:53–58.
Midorikawa H, Ogawa T, Satou K, Hoshino S. Clinical results of open stent grafting applied using an improved endotracheal tube in the treatment of high-risk patients with distal arch aneurysms. J Artif Organs 2004;7:128–132.
Tamura K, Nomura F, Mukai S, Ihara K. Pitfalls in open stent grafting for distal aortic arch aneurysm. Jpn J Cardiovasc Surg 2002;31:139–142.
Yoshitaka H, Tushima Y, Kuinose M, Ishida A, Minami K, Totukawa T, et al. An open stent grafting for aortic arch replacement, afterward? Jpn J Cardiovasc Surg 2007;36(suppl):187.
Nakamura E, Matuyama M, Nina K, Nishimura M. Problems and efficacy of open stent grafting for arch replacement. Jpn J Cardiovasc Surg 2007;36(suppl):280.
Sanada J, Matsui O, Terayama N, Kobayashi S, Minami T, Kurozumi M, et al. Clinical application of a curved nitinol stent-graft for thoracic aortic aneurysms. J Endovasc Ther 2003;10:20–28.
Midorikawa H, Satou K, Ogawa T, Hoshino S. Open stent-grafting applied with the Matsui-Kitamura stent to a distal arch aneurysm. Jpn J Thorac Surg 2006;59:455–458.
Greenberg R, Resch T, Nyman U, Lindh M, Brunkwall J, Brunkwall P, et al. Endovascular repair of descending thoracic aortic aneurysms: an early experience with intermediate-term follow-up. J Vasc Surg 2000;31:147–156.
Dake MD, Miller DC, Mitchell RS, Semba CP, Moore KA, Sakai T. The “first generation” of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta. J Thorac Cardiovasc Surg 1998;116:689–704.
Akasaka J, Tabayashi K, Saiki Y, Oda K, Kumagai K, Iguchi A. Stent grafting technique using Matsui-Kitamura (MK) stent for patients with aortic arch aneurysm. Eur J Cardiovasc Surg 2005;27:649–653.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Midorikawa, H., Kanno, M. & Ishikawa, K. Fully supported open stent grafting applied with a Matsui-Kitamura (MK) stent in treatment of distal arch aneurysm. Gen Thorac Cardiovasc Surg 56, 209–214 (2008). https://doi.org/10.1007/s11748-007-0223-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-007-0223-6