Aortic root reinforcement combined with vascular grafts built-in and intermittent anastomosis technique (XJ-procedure) for acute type A aortic dissection surgery
10.3760/cma.j.cn112434-20231017-00090
- VernacularTitle:根部加固联合人工血管内置间断吻合技术(XJ-Procedure)在急性A型主动脉夹层中的应用
- Author:
Jing LI
1
;
Changying ZHAO
;
Xinglong ZHENG
;
Yongjian ZHANG
;
Liang ZHONG
;
Yongxin LI
;
Lizhong SUN
;
Yang YAN
Author Information
1. 西安交通大学第一附属医院心血管外科，西安 710061
- Publication Type:Journal Article
- Keywords:
XJ-procedure;
Aortic root reinforcement;
Acute type A aortic dissection
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(12):736-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study proposed a novel technique for aortic root reconstruction and evaluated its safety and effectiveness.Methods:Acute type A aortic dissection (ATAAD) patients who underwent Sun' s procedure from January 2020 to June 2022 in the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively enrolled. These patients were divided into three groups according to their surgical procedures of aortic root: aortic root reinforcement combined with vascular grafts built-in and intermittent anastomosis technique (XJ-procedure) group, continuous suture and pledgeted interrupted reinforcement group and Bentall group. The perioperative data and postoperative follow-up results of the three groups were compared to analyze the efficacy of XJ-procedure in the root treatment of ATAAD.Results:A total of 509 patients were enrolled in this study, including 288 patients in the XJ-procedure group, 132 patients in the continuous suture and pledgeted interrupted reinforcement group and 89 patients in the Bentall group. The 30-day mortality of all patients was 7.5% (38/509), and were 7.3%, 8.3% and 6.7% in the XJ-procedure group, continuous suture and pledgeted interrupted reinforcement group and Bentall group, respectively. The operation time of the XJ-procedure group [355 (320, 380) min] was significantly lower than the other two groups. The cardiopulmonary bypass time [154 (140, 169) min] and the aortic cross-clamping time [80 (72, 89) min] of XJ-procedure group were lower than the Bentall group [166 (147, 184) min and 86 (77, 96) min]. The aortic root bleeding that required secondary cardiopulmonary bypass did not occur in the XJ-procedure group. There was no significant difference in early postoperative complications among the three groups. The incidence of residual aortic root dissection before discharge, in 3 and 6 months after operation was lower in the XJ-procedure group compared to the continuous suture and pledgeted interrupted reinforcement group ( P<0.001). Conclusion:The XJ-procedure technique is a safe, simple and mastered method for the aortic root treatment of ATAAD, which shows an accurate early clinical effect.
