Application of modified David technique to aortic sinus repair in acute type A aortic dissection
10.3760/cma.j.issn.1001-4497.2019.12.005
- VernacularTitle: 改良David技术在急性A型主动脉夹层窦部成形中的应用
- Author:
Long WU
1
;
Kailun ZHANG
1
;
Xiaofan HUANG
1
;
Xianqing FENG
1
;
Yu SONG
1
;
Baoqing LIU
1
;
Xionggang JIANG
1
;
Nianguo DONG
1
Author Information
1. Department of Cardiovascular Surgery, Union Hospital, Huazhong University of Science and Technology, Wuhan 430022, China
- Publication Type:Journal Article
- Keywords:
Aortic dissection;
David procedure;
Aotic sinus repair
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(12):731-734
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the effect of modified David technique on acute type A aortic dissection sinus formation.
Methods:From March 2018 to September 2018, modified David technique was applied to aortic sinus remodeling in acute A-type aortic dissection in 19 patients, 13 males and 6 females. The age was 45-67(50.42±15.37) years old and the weight was 45-112(60.32±25.18) kg. Single sinus(noncoronary sinus) was repaired in 15 cases, double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 2 cases, left sinus Florid sleeve technical treatment plus double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 1 case, Single sinus(noncoronary sinus) repaired and aortic vavle replacement in 1 case. Frozen elephant trunk and total arch replacement in 13 cases, hemiarch replacement in 3 cases.
Results:There were no deaths in this group. The cardiopulmonary bypass time was 176-245(193.27±32.46) minutes, the aortic cross clamp time was 105-187(122.36±18.57)minutes, and the operation time was 6.5-11.0(7.63±1.31) hours. The mechanical ventilation time was 18-122(48.27±34.73)hours, the intensive care unit stay time was 2-10(5.35±2.62) days, and the postoperative hospital stay was 7-22(12.63±3.25)days. There was no delayed sternal closure during operation, and there was no secondary thoracotomy after operation. One patient developed a transient advanced atrioventricular block. Transient neurological dysfunction was observed in 5 patients. All patients were followed up for more than half a year. The color Doppler echocardiography and computed tomography angiograph(CTA)showed no aortic regurgitation or residual dissection.
Conclusion:The application of modified David technique in the remodeling of aortic root sinus in acute type A aortic dissection is an effective technique with relatively simple process, which is worth promoting.
