A comparison of Sun’s operation and ascending aorta replacement combined with open placement of triple-branched stent graft in treatment of type A aortic dissection
10.11958/20150247
- VernacularTitle:孙氏手术与三分支主动脉弓覆膜支架治疗Stanford A型主动脉夹层的效果比较
- Author:
Feng CHENG
;
Qingliang CHEN
;
Nan JIANG
;
Tongyun CHEN
;
Feng ZHAO
- Publication Type:Journal Article
- Keywords:
aortic diseases;
operation;
treatment outcome;
Sun’s operation;
open placement of triple-branched stent graft;
aortic dissection
- From:
Tianjin Medical Journal
2016;44(8):951-954
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.
