Response to Letter Regarding Article, “Extensive Primary Repair of the Thoracic Aorta in Acute Type A Aortic Dissection by Means of Ascending Aorta Replacement Combined With Open Placement of Triple-Branched Stent Graft: Early Results”
We read the letter by Drs Murzi and Glauber with interest. To the best of our knowledge, a single-stage hybrid procedure (ascending aorta and aortic arch were replaced, and a stent graft was implanted into the descending aorta) for type A acute aortic dissection has been widely accepted as the preferred surgical treatment to greatly benefit patients when extensive thoracic aorta repair is needed.1,2 Given our experience with 30 cases, we believe that the benefit of our technique is that it can be used not only to obtain a primary repair and reduce the risk of late aneurysm formation and the need for distal reoperation, but also to offer a less invasive procedure with less morbidity and to more easily manage a distal anastomosis once reoperation is needed.3 We have found that placement of our triple-branched stent graft into the true lumen of the proximal descending aorta, arch, and 3 arch vessels, directed by intraoperative transesophageal echocardiography, is relatively easy.3 Furthermore, data from multiple centers, including ours, demonstrate that this hybrid technique is a simple and effective procedure with satisfactory early results.1,–,3
Although initial reports using our technique have been encouraging, the number of patients was small, and the data were preliminary; long-term outcomes are unknown. Therefore, we deem longer follow-up to be necessary to demonstrate the benefit from the use of our procedure in the future.
Liang-Wan Chen, MD
Xiao-Fu Dai, MD
Lin Lu, MD
Gui-Can Zhang, MD
Hua Cao, MD
Department of Cardiac Surgery
Fujian Medical University
Fuzhou, Fujian, China
- © 2011 American Heart Association, Inc.