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℃).