Operative technique
All surgical patients started from the median sternum incision, and all
received FET treatment for the dissection of the distal descending
aorta. According to the length of the trunk, there are two groups of
long and short trunks. The aortic repair in the short trunk group is
performed under cardiopulmonary bypass and deep-moderate hypothermic
circulatory arrest (20~25℃), and the patients in this
group are mainly unilateral cerebral perfusion. For patients in the long
stent group, surgery was mainly performed under cardiopulmonary bypass
and moderate-to-light hypothermic circulatory arrest
(25~30℃), and most patients with long trunks received
bilateral cerebral perfusion.
Determination of the FET diameter was based on the measurement of
preoperative CT. The size of FET was selected based on the TL diameter
measured by preoperative CT or the direct measurement of descending
aortic TL during the operation.
We followed a protocol aimed at preventing spinal cord ischemia (SCI),
especially when performing long FET surgery, which was a standard
procedure for our surgical team. Including the lower extremities were
perfused through the femoral artery, when the circulation was arrested.
Bilateral cerebral perfusion was through the innominate artery, left
common carotid artery or axillary artery, and the circulation was
arrested at moderate to mild hypothermia (25~30℃).