Different surgical procedures for Stanford type A aortic dissection: A case control study
10.7507/1007-4848.201810001
- VernacularTitle:两种术式治疗 Stanford A 型主动脉夹层的病例对照研究
- Author:
ZHAO Yinglu
1
;
WANG Weifan
1
;
WANG Wei
1
;
HE Fengxiao
1
;
WANG Shixiong
1
;
XUE Yu
1
;
MA Qi
1
;
GAO Bingren
1
;
LIU Debin
1
Author Information
1. Department of Cardiac Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, P.R.China
- Publication Type:Journal Article
- Keywords:
Sun's procedure;
endovascular stent-graft;
debranching;
Stanford type A aortic dissection
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(7):664-669
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the near-term clinical efficacy of two different surgical procedures (Sun's procedure and Debranching combined endovascular stent-graft procedure) to cure Stanford type A aortic dissection, and summarize the clinical experience to help better master the indications of the two surgical procedures. Methods We retrospectively analyzed the clinical data of 46 patients with Stanford A aortic dissection in our hospital between September 2014 and September 2017. There were 39 males and 7 females at age of 20–74 (48.67±11.80) years. According to different surgical methods, the patients were divided into a Sun's procedure group (26 patients) and a debranching combined endovascular stent-graft procedure group (20 patients). The clinical effect of the two groups was compared. Results The debranching combined endovascular stent-graft procedure group was significantly superior to the Sun's group in cardiopulmonary bypass (CPB) time, aortic cross clamp(ACC) time, intraoperative urine output, postoperative mechanical ventilation time, postoperative 24 h volumes of drain, CICU time, renal function recovery of postoperative 72 h and total hospital stay(P<0.05). The incidence of transient neurological damage after operation in the debranching combined endovascular stent-graft procedure group was significantly lower than that of the Sun's procedure group(P<0.05). The follow-up time ranged from 3 to 36 months. And the follow-up rate was 90.5%. One patient in the Sun's procedure group died of serious pulmonary infection postoperative 30 days. One patient in the debranching combined endovascular stent-graft group was found to have internal leakage in the early postoperative examination and disappeared after 6 months. Sun's procedure group did not find endoleak. All patients during the follow-up time did not appear brain, coagulation disorders, stroke, paraplegia, upper limb ischemia and other complications. Conclusion For Stanford type A aortic dissection, debranching combined surgery may have the risk of postoperative endoleak, but the overall effect is superior to Sun's operation. Therefore, debranching combined surgery should be preferred for the treatment of this type of dissection.
