Influence of aortic root repair and replacement on the surgical effect and postoperative complications of Stanford type A aortic dissection patients
10.3760/cma.j.cn115396-20241130-00365
- VernacularTitle:主动脉根部修复术与置换术对Stanford A型主动脉夹层患者手术效果和术后并发症的影响
- Author:
Chuanwen LI
1
;
Qingyan SUN
;
Yanqing GAN
;
Xianqing LI
;
Teng CAI
;
Hongsheng LIU
;
Liangchun NI
Author Information
1. 济宁医学院附属医院心脏外科，济宁 272029
- Keywords:
Aorta;
Interlayer;
Replacement;
Reconstructive surgical procedures;
Postoperative complications
- From:
International Journal of Surgery
2025;52(3):176-181
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of aortic root repair and replacement on the surgical effect and postoperative complications of Stanford type A aortic dissection.Methods:By retrospective case-control study, 190 patients with Stanford type A aortic dissection admitted to the Affiliated Hospital of Jining Medical College from August 2020 to December 2023.According to the different surgical treatment methods, they were divided into repair group ( n=65) and replacement group ( n=125). Patients in the repair group received aortic root repair, while patients in the replacement group received aortic root replacement, that was, Bentall operation. The surgical related indexes, surgical effect, postoperative outcome and mid-term survival rate of the two groups were compared. The measurement data conforming to the normal distribution were expressed by the mean standard deviation ( ± s), and the comparison between groups adopted t-test; The measurement data of skewed distribution were expressed by M( Q1, Q3), and the comparison between groups was conducted using the rank sum test. Counting data were expressed by the number of cases and percentage (%), and the comparison between groups was conducted by chi-square test or Fisher exact probability method. Results:There was no significant difference in distal aortic operation, cardiopulmonary bypass time, hypothermic circulatory arrest time and occlusion time between repair group and replacement group ( P>0.05).There was no significant difference in ventilator-assisted time, intensive care unit stay time, visual analogue score(VAS) after waking up and hospitalization time between repair group and replacement group ( P>0.05).There was no significant difference between the two groups in 30-days mortality rate after discharge (9.2% vs 11.2%) and postoperative complications (18.5% vs 22.4%) ( P>0.05). Kaplan-Meier survival curve analysis showed that there was no significant relationship between the medium-term survival rate of patients in repair group and replacement group ( χ2=0.46, P=0.500). During the follow-up period, one patient in the replacement group underwent reoperation, including Bentall operation, with an interval of 14 months. Conclusions:the choice of aortic root repair or replacement has no effect on the surgical effect and postoperative complications of Stanford A aortic dissection patients. The short-term and medium-term survival rate of aortic root repair is similar to that of replacement, and no patient received proximal surgery again during the follow-up period, which is feasible and safe.
