The mid-term results of the staged total aortic replacement in Stanford type A aortic dissection
10.3760/cma.j.issn.1001-4497.2018.04.002
- VernacularTitle:Stanford A型主动脉夹层分期全主动脉替换术的近中期结果
- Author:
Jianmao HONG
1
;
Yipeng GE
;
Lijian CHENG
;
Haiou HU
;
Ruidong QI
;
Zhiyu QIAO
;
Chengnan LI
;
Tie ZHENG
;
Lei CHEN
;
Jun ZHENG
;
Yongmin LIU
;
Junming ZHU
;
Lizhong SUN
Author Information
1. 100029,首都医科大学附属北京安贞医院心血管外科北京市大血管疾病诊疗研究中心北京市心肺血管疾病研究所 首都医科大学附属北京安贞医院心脏外科
- Keywords:
Aortic dissection;
Aortic aneurysm;
Total aortic replacement
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(4):196-199
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the mid-term results of the staged total aortic replacement in Stanford type A aortic dissection.Methods During March 2009 to September 2016,a total of 49 patients with Stanford type A aortic dissection in Beijing Anzhen Hospital cardiovascular center underwent total aortic replacement with a median age of 36 (27,41 years),male 36 (73.5％) cases.30 (61.2％) cases of them combined with Marfan syndrome.Results The interval between two stage operation was 23 (10,57) months.In the first stage operation,45 (91.8％) cases underwent Sun's procedure,2 (4.1％) underwent total aortic arch replacement,2 (4.1％) cases underwent classic elephant trunk and total aortic arch replacement.All patients underwent thoracoabdominal aortic repair(TAAAR).Deep hypothermic circulatory arrest surgery was 12(24.5％)cases in the second stage.7 (14.3％)cases dead postoperative.Spinal cord related complications happened in 3 (6.1％) cases with stroke in 2(4.1％) cases,acute renal insufficiency in 7(14.3 ％) cases,respiratory insufficiency in 7 cases (14.3％),re-operation for hemostasis in 3 (6.1％) cases and gastrointestinal bleeding in 3 cases(6.1％).Univariate analysis showed that the interval between two stage operation,operation time,deep hypothermic circulatory arrest surgery are risk factors for in-hospital mortality;multivariate analysis showed that deep hypothermic circulatory arrest surgery and the interval between two stage operation were independent risk factors for in-hospital mortality.3 years,5 years survival rate were 94.4％ and 78.7％.Conclusion For Stanford type A dissection especially the thoracoabdominal aortic expands,staged total aortic replacement shows good mid-term results.Block stentgraft can reduce the use of deep hypothermic circulatory arrests to decrease the mortality.
