Purpose. The objective of this investigation was to study the early efficacy of in situ fenestration with triple chimney technique for high-risk type A aortic dissection patients. Methods. This study included 24 patients who were treated by in situ fenestration with TCT for high-risk TAAD between January 2018 and December 2019. Multiple comorbidities or preoperative critical conditions rendered patients ineligible for open surgery, but all patients that were evaluated and considered had to undergo operation. By analyzing the regular follow-up data, the early postoperative efficacy of the patients was evaluated. Results. The average age of the 24 patients was 65.4 ± 9.3 years. The success rate of the operation was 100%, as all the patients were discharged successfully. There were no serious neurological complications or persistent endoleakage. The mean follow-up time was 21.4 ± 6.9 months. The patency rate of all branching stents was 100%, with no stent displacement, stenosis, or blockage observed. While none presented with type I endoleakage, one patient (4.2%) presented asymptomatic type II endoleakage around the left subclavian artery stent. Currently, 23 of the 24 patients remain alive. Conclusion. Initial results are encouraging with TCT for high-risk TAAD. However, due to its high selectivity and potential complexity related to surgical risks, the mid- and long-term efficacy of this technique remains unknown. For patients who are eligible for open heart surgery, we still recommend it be performed.

中文翻译：

---

三烟囱技术原位开窗治疗高危斯坦福 A 型主动脉夹层的早期疗效：一项单中心回顾性研究

目的。本研究的目的是研究采用三烟囱技术原位开窗对高危 A 型主动脉夹层患者的早期疗效。方法。本研究包括 24 名在 2018 年 1 月至 2019 年 12 月期间接受 TCT 原位开窗治疗的高危 TAAD 患者。多种合并症或术前危重情况使患者不适合开腹手术，但所有接受评估和考虑的患者都必须接受手术。通过分析定期随访资料，评价患者术后早期疗效。结果。24 名患者的平均年龄为 65.4 ± 9.3 岁。手术成功率100%，所有患者均顺利出院。没有严重的神经系统并发症或持续性内漏。平均随访时间为 21.4 ± 6.9 个月。所有分支支架的通畅率为100%，未观察到支架移位、狭窄或阻塞。虽然没有人出现 I 型内漏，但一名患者 (4.2%) 在左锁骨下动脉支架周围出现无症状的 II 型内漏。目前，24名患者中有23人还活着。结论. TCT 治疗高危 TAAD 的初步结果令人鼓舞。然而，由于其高选择性和与手术风险相关的潜在复杂性，该技术的中长期疗效仍然未知。对于有资格进行心脏直视手术的患者，我们仍然建议进行。