Sun' s procedure with preservation of autologous brachiocephalic vessels for chronic type A aortic dissection
10.3760/cma.j.issn.1001-4497.2018.05.007
- VernacularTitle:保留自体头臂血管孙氏手术治疗慢性A型主动脉夹层
- Author:
Zhiyu QIAO
1
;
Yongliang ZHONG
;
Ruidong QI
;
Yipeng GE
;
Lijian CHENG
;
Chengnan LI
;
Wei LIU
;
Lei CHEN
;
Junming ZHU
Author Information
1. 100029,首都医科大学附属北京安贞医院心血管外科 北京市心肺血管疾病研究所 北京市大血管疾病诊疗研究中心 北京市大血管外科植入式人工材料工程技术研究中心
- Keywords:
Chronic type A aortic dissection(CTAD);
Sun' s procedure;
Total arch replacement;
En block technique
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(5):292-295
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical outcomes and surgical indications for chronic type A aortic dissection (CTAD) by using Sun's procedure with preservation of autologous brachiocephalic vessels.Methods From September 2010 to December 2013, 23 patients with CTAD underwent Sun's procedure with preservation of autologous brachiocephalic vessels under moderate hypothermic circulatory arrest combined with selective cerebral perfusion in our center .The data was collected and analysed retrospectively.There were 20 males and 3 females patients with a mean age of(49.91 ±10.05) years.Preopera-tive comorbidities included Marfan syndrome in 1 patient, isolated left vertebral artery in 1, hypertension in 19, coronary artery disease in 2, heart dysfunction in 1, renal insufficiency in 1, mitral regurgitation in 1, and pulmonary infection in 1.Previous operation history included thoracic endovascular aortic repair in 3, percutaneous coronary intervention in 1, aortic valve re-placement in 1, Bentall procedure in 1, and coronary artery bypass grafting in 1.Results The average operation time, car-diopulmonary bypass time, aortic cross clamping time and selective cerebral perfusion time was(6.43 ±1.03) h,(167.07 ± 49.62) min,(80.74 ±29.00) min, and(27.35 ±6.03) min, respectively.Concomitant procedures included Bentall proce-dure in 6 patients, ascending aorta replacement in 17, ascending aorta-femoral artery bypass in 1, mitral valvuloplasty in 1, and CABG in 1.There were 2(8.70%) in hospital deaths.Three patients suffered temporary renal dysfunction, and 1 with re-nal failure recieved continuous renal replacement therapy .Postoperative hypoxemia were found in 2 patients, and 1 of them re-ceived reintubation.These patients recovered before discharge.The mean follow-up time was(52.52 ±9.89) months with a follow-up rate of 95.23%(20/21).One patient suffered cerebral embolism but recovered soon after treatment.The others were free from any complications.Conclusion Sun's procedure with preservation of autologous brachiocephalic vessels simplified the aortic arch surgery and obtained satisfactory outcomes for suitable patients with CTAD , but surgical indications should be strictly considered.
