Short-term effects of extended adventitial inversion with graft eversion anastomosis technique in the root treatment of acute type A aortic dissection
- VernacularTitle:扩大主动脉外膜内翻并人工血管端翻转吻合处理急性A型主动脉夹层根部的近期效果
- Author:
Xuezhi HE
1
;
Feng GAO
1
;
Yang GAO
1
;
Lei SHI
1
;
Xijing ZHUANG
1
;
Wei LIU
1
;
Wenjun WANG
1
;
Zepeng SHI
1
Author Information
1. Department of Cardiovascular Surgery, Dalian Municipal Central Hospital, Dalian, 116033, Liaoning, P. R. China
- Publication Type:Journal Article
- Keywords:
Adventitial inversion;
eversion anastomosis;
aortic dissection;
aortic root;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(03):371-376
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the short-term therapeutic effect of extended adventitial inversion with graft eversion anastomosis technique in the root treatment of acute type A aortic dissection (ATAAD). Methods From November 2019 to July 2020, 28 patients with ATAAD were treated by extended adventitial inversion with graft eversion anastomosis technique in the Department of Cardiovascular Surgery, Dalian Municipal Central Hospital, including 19 males and 9 females, aged 60.11±11.11 years. The intima of the ascending aorta was trimed to 5 mm above the sinotubular junction. The adventitia of the ascending aorta was longitudinally cut to the reserved intima margin along the junction of the three aortic valves. The extended adventitial inversion was sutured continuously, no coronary sinus was sutured over the aortic annulus, and the left and right coronary sinus was sutured above the coronary ostium. The anastomotic graft was everted and inserted into the aortic lumen, and the everted graft was continuously sutured at the level of sinotubular junction which was 5 mm away from the edge of graft. Results There was no intraoperative death, intractable root hemorrhage, residual root false lumen, root dilatation, anastomotic hematoma or other complications. There was no recurrence of the pain in the back of all patients, and the results of the CT angiography were not significantly changed. In 22 patients with no regurgitation, only 1 (4.55%) patient had a mild regurgitation. In 6 patients with mild aortic regurgitation, the disappearance rate of regurgitation was 50.0% (3/6). Conclusion The treatment of extended adventitial inversion with graft eversion anastomosis technique in the root treatment of aortic dissection eliminates the residual dissection at the root. The anastomotic hemorrhage is prevented, the root structure of aortic dissection is reconstructed and strengthened, the root function is restored, and the possible expansion of the root is prevented. The short-term results are satisfactory.
