Modified total arch replacement for surgical repair of Stanford type A aortic dissection
10.7507/1007-4848.201803073
- VernacularTitle:改良全弓置换技术在 Stanford A 型主动脉夹层手术中的应用
- Author:
CAI Shihao
1
,
2
;
FAN Xiaoping
3
;
HUANG insong
3
;
PENG Jihai
4
;
ZHANG Mingsheng
4
;
HE Jie
1
,
2
;
XU Wenliu
5
Author Information
1. 1Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China
2. 3. Graduate School, the Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, P.R.China
3. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China
4. Department of Rehabilitation, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China
5. Graduate School, the Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, P.R.China
- Publication Type:Journal Article
- Keywords:
Aortic dissection;
surgery;
hypothemia;
selective cerebral perfusion
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(11):962-966
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and effectiveness of modified total arch replacement by retrospectively analyzing the clinical outcome of surgical patients with Stanford type A aortic dissection (AAD). Methods From June 2015 to December 2016, 39 consecutive patients with AAD were recruited to this study. This modified technique was preformed under general anesthesia and a 30℃ hypothermia circulatory arrest (HCA) with continual bilateral antegrade cerebral perfusion. Different surgical approaches were applied according to the aortic root condition: Bentall procedure (4 patients), David procedure (2 patients), aortic valve plasty and ascending aortic replacement (25 patients) and Cabrol procedure (8 patients). Concomitant procedures included mitral valve plasty (1 patient) and tricuspid valve plasty (1 patient). Results The average cardiopulmonary bypass (CPB), aortic occlusion time (ACC), HCA and operation time was 218.5±42.2 min, 134.2±32.4 min, 4.9±2.3 min and 415.5±80.5 min respectively. Four patients required dialysis and 2 patients developed temporary neurological deficit. No permanent neurological deficit, postoperative paraplegia or in-hospital death occurred. Computed tomography examination was performed on all patients before discharge and 3 months after discharge. The follow-up result showed that 37 patients developed complete thrombosis in the false lumen and 2 patients developed partial thrombosis. Conclusion Modified total arch replacement is a safe and effective approach for AAD. It can greatly avoid postoperative complications and provide satisfactory short-term outcomes.
