INTRODUCTION: The authors describe the implantation of an endovascular self-expanding stents grafts at 33 months of follow-up. The use can be a new alternative for the treatment of descending aortic dissections and aneurysms disease. MATERIAL AND METHODS: From April 1998 to November 2000 (32 months), 37 endovascular stent grafts were implanted, 21 in acute dissections type B, 7 in acute dissections type A and 9 in chronic dissections type B and aneurysms ones. The age varied between 39 and 79 years (mean=57.94 ± 1.91 years), considering that 64.86% were male patients. The patients were submitted to median esternotomy, extracorporeal circulation (ECC), with deep hipothermia (18-20ºC), total circulatory arrest (TCA), and retrograde cerebral perfusion (RCP). The transverse aorta was incised and the stent was implanted in the descending proximal aorta with the aid sometimes of aortoscopy. The times of ECC, aortic clamping, TCA, RCP, rewarming, mechanic ventilation, hospitalization, trans and post-operative bleeding, blood replacement, events curve and survival curve were analyzed. RESULTS: The hospital mortality (30 days) was 13.51%; 32 have been followed up from 1 to 33 months, 70.7% are free of events and survival curve with 63.19% (33 months). CONCLUSIONS: The implant of self-expanding intraluminal stent grafts presented has lower hospital mortality in the acute phase and follow-up in acute aortic dissections type B (10%) than clinical treatment (IRAD). In spite of the small sample the procedure is promising and needs longer follow-up.
Aneurysm, dissecting; Aortic aneurysm; Stents; Cardiovascular surgical procedures; Cardiovascular surgical procedures; Cardiovascular surgical procedures
