Harbin Medical University performs first dual-branch stent aortic surgery

Author: Professor Xie Baodong, Reviewer: N/A, Curator: N/A, Production/Organizational Information: Harbin Medical University First Affiliated Hospital. Recently, Professor Xie Baodong from the Department of Cardiothoracic Surgery at the First Affiliated Hospital of Harbin Medical University led a team to successfully implant a dual-branch intravascular stent system in a 73-year-old patient suffering from acute Stanford Type A aortic dissection. This procedure marks the first clinical application of this type of stent in the country and offers a new treatment option for elderly patients with urgent aortic dissection.

The patient is a 73-year-old male who was admitted due to an acute aortic dissection. Preoperative examinations indicated that the dissection was extensive, involving the ascending aorta, the aortic arch, and the descending aorta down to the abdominal aorta, with multiple important branch vessels affected, suggesting a high surgical complexity. Intraoperatively, further exploration confirmed disease progression, revealing approximately 200ml of hemorrhagic effusion in the pericardial cavity, significantly worsening compared to preoperative imaging, indicating a high risk of rupture. The ascending aorta was notably dilated and displayed a bluish-purple color, with a clear formation of the aortic dissection. The tear was located at the root of the aorta, about 1cm above the right non-coronary cusp of the aortic valve, which still exhibited acceptable opening and closing function.

After thorough assessment, the surgical team decided to implement a combined approach using a dual-branch intraoperative stent system within the framework of traditional standards for aortic valve replacement and total arch reconstruction. This strategy aims to achieve synchronous reconstruction of the aortic arch and descending aorta while ensuring treatment integrity and optimizing the overall surgical process. During the procedure, the dual-branch stent system was implanted, and the distal end of the synthetic graft was nested within the proximal end of the stent's synthetic graft to secure the connection. Following the restoration of circulation, the heart successfully resumed its rhythm, the anastomosis of the brachiocephalic artery was completed, and rewarming was gradually initiated, leading to a smooth conclusion of the procedure. Overall, the surgical process was stable.

The surgery lasted approximately 4 hours, during which the extracorporeal circulation time was 85 minutes, and the stent implantation procedure took only 5 minutes. The patient recovered smoothly after the operation and was weaned off the ventilator 8 hours later, with stable vital signs.

According to Professor Xie Baodong, this stenting system utilizes a structured design that allows for key steps to be assisted by instruments, thereby reducing the number of deep anastomoses required in traditional surgeries. This not only decreases the complexity of the procedure but also helps shorten operation time and reduce the risks of postoperative complications such as stroke, anastomotic bleeding, and infection. For elderly patients or those with lower surgical tolerance due to emergency conditions, this technology offers a better option for the surgical treatment of complex aortic diseases.

The successful completion of this surgery marks a new technical advancement for Harbin Medical University First Hospital in the field of surgical treatment for complex aortic diseases in China, providing new technological and solution support for treating related patients.