Surgical treatment of Stanford type A aortic dissection after coronary artery stenting
- VernacularTitle:冠状动脉支架植入术后Stanford A型主动脉夹层的外科治疗
- Author:
Shichao GUO
1
;
Zhiyu QIAO
1
;
Chengnan LI
1
;
Lizhong SUN
1
;
Junming ZHU
1
Author Information
1. Beijing Institute of Heart, Lung and Blood Vessel Disease of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing, 100029, P. R. China
- Publication Type:Journal Article
- Keywords:
Aortic dissection;
misdiagnosis;
iatrogenic;
percutaneous coronary intervention;
Sun’s procedure
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(01):111-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively analyze the surgical treatment of Stanford type A aortic dissection after coronary artery stenting, and to explore the surgical techniques and surgical indications. Methods Clinical data of 1 246 consecutive patients who underwent operations on Stanford type A aortic dissection from April 2016 to July 2019 in Beijing Anzhen Hospital were retrospectively analyzed. Patients with Stanford type A aortic dissection after coronary artery stenting were enrolled. Results Finally 19 patients were collected, including 16 males and 3 females with an average age of 54±7 years ranging from 35 to 66 years. There were 11 patients in acute phase, 15 patients with AC (DeBakey Ⅰ) type and 4 patients with AS (DeBakey Ⅱ) type. In AC type, there were 10 patients receiving Sun's surgery and 5 patients partial arch replacement. Meanwhile, coronary artery bypass grafting was performed in 7 patients and mitral valve replacement in 1 patient. Stents were removed from the right coronary artery in 4 patients. In this group, 1 patient died of multiple organ failure in hospital after operation combined with malperfusion of viscera. Eighteen patients recovered after treatment and were discharged from hospital. The patients were followed up for 30 (18-56) months. One patient underwent aortic pseudoaneurysm resection, one thoracic endovascular aortic repair, one emergency percutaneous coronary intervention due to left main artery stent occlusion, and one underwent femoral artery bypass due to iliac artery occlusion. Conclusion Iatrogenic aortic dissection has a high probability of coronary artery bypass grafting at the same time in patients with Stanford type A aortic dissection after coronary artery stenting. Complicated type A aortic dissection after percutaneous coronary intervention should be treated with surgery aggressively.
