Efficacy and safety of total aortic arch replacement in elderly patients with Stanford type A aortic dissection
10.3760/cma.j.issn.0254-9026.2022.01.013
- VernacularTitle:老年Standford A型主动脉夹层患者全主动脉弓置换的效果及安全性
- Author:
Gang QIAO
1
;
Zhidong ZHANG
;
Gangqiang ZOU
;
Zhigang SUN
;
Zhenfeng HUANG
;
Xiaoshan CHEN
;
Wei LU
;
Jianyang LIU
;
Guangfeng LI
Author Information
1. 阜外华中心血管病医院大血管外科 河南省心脏中心，郑州 450000
- Keywords:
Aneurysm, dissecting;
Total arch replacement;
Hybrid surgery
- From:
Chinese Journal of Geriatrics
2022;41(1):62-65
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of total aortic arch replacement in elderly patients with Stanford type A aortic dissection(TAAD).Methods:In this retrospective study, a total of 481 TAAD patients treated with total arch replacement in our hospital from January 2016 to January 2020 were divided into three groups: aged≤59 years, 60-69 years and ≥70 years.The differences between three groups in surgical method, extracorporeal circulation time, blocking time, circulatory time, stopping time, surgical time, ventilator use time, ICU time, hospitalization time, treatment rate of continued renal replacement, fatality rate, and cause of death were statistically analyzed and compared.Results:There were statistically significant differences in the stopping time between any two groups of the three groups(all P<0.05). The older the age, the shorter the circulatory arrest time.The difference of ventilator time and ICU time between ≤59 and 60-69 years was statistically significant( P<0.01). Patients with continuous renal replacement(CRRT)were 19.0%(71/373)in ≤59 years, 23.1%(18/78)in 60~69 years, and 26.7%(8/30)over 70 years.In-hospital mortality was 35/373(9.4%)in the group of ≤59 years old, 11/78(14.1%)in the group of 60~69 years old, and 5/30(16.7%)in the group of ≥70 years old.There was no death in patients undergoing type Ⅱ hybrid surgery. Conclusions:Age is one of the important death factors after total aortic arch replacement in TAAD patients.Total aortic arch replacement is an acceptable surgical method for elderly patients with TAAD.Hybridization may reduce hospitalization death in elderly patients.
