Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root

Han, Qing-qi; Song, Zhigang; Zou, Liang-jian; Han, Lin; Lu, Fanglin; Lang, Xilong; Xu, Zhiyun

doi:10.5935/1678-9741.20130028

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…Han et al [Han 2013] described an aortic root reconstructive approach, including the insertion of an autologous pericar¬dial patch in the false lumen, lining of the STJ lumen with a polyester vascular ring and wrapping the vessel with Teflon strips for reinforcement with low rates of in-hospi¬tal/ follow-up mortality and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…Freedom from aortic root reoperation in patients, who have undergone aortic root reconstruction for ATAAD, has been reported to be between 69% and 95% at 10 years [Rylski 2013;Von Segesser 1996;Mazzucotelli 1993;Rylski 2014]. On the other hand, Han et al [Han 2013] reported that none of their patients experienced postoperative recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm and they attributed that to their reinforcement technique, which eliminated the intimal and adventitial fragility and prevented blood exudation into the extravascular space or formation of pseudoaneurysm under the adventitia.…”

Section: Discussionmentioning

confidence: 99%

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Reinforced Aortic Root Reconstruction in Type A Aortic Dissection: A Prospective Study

Elsharkawy

Midany

Elwakeel

et al. 2021

HSF

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Background: Type A aortic dissection is a challenging surgical emergency associated with high morbidity and mortality. Many techniques have evolved to repair the dissected sinus segments and restore aortic valve dynamics. Herein, we evaluate the early outcome of a novel technique for reconstruction of dissected aortic root. Methods: A prospective study was conducted on 300 patients to evaluate the early results of repair of dissected root in type A aortic dissection. The mean age was 59.65±8.52 years, and 76% of patients were males. All patients had four standard steps for aortic reconstruction: 1) commissural resuspension; 2) right coronary sinus reinforcement with pericardial and Dacron bands; 3) non-coronary sinus reinforcement using external Dacron patch; 4) circumferential inversion of adventitial layer of the root. Patients were followed up clinically, echocardiographically, and by CT scan. Results: The in-hospital mortality was 8%. The mean cross-clamp time was 120±30 minutes, and circulatory arrest time was 25+10 minutes. Twenty-seven patients (9%) experienced postoperative complications, including bleeding and acute kidney injury. During a mean follow-up time of 48±12 months, there were no recurrent aortic dissection, aortic dilatation, pseudoaneurysm, or progression of aortic regurgitation during the entire study period. Conclusions: This reconstructive technique technically is undemanding, feasible, safe, and durable with good early results. A larger cohort of patients with longer period of follow up should generate a more powerful evaluation of this technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reinforced Aortic Root Reconstruction in Type A Aortic Dissection: A Prospective Study

Elsharkawy

Midany

Elwakeel

et al. 2021

HSF

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“…Nesse estudo, os autores, cirurgiões, trazem uma nova abordagem para o tratamento cirúrgico de reconstrução de dissecção aórtica aguda tipo A com acometimento da raiz aórtica e, com ele, suas análises peri e pós-operatórias da técnica cirúrgica empregada, complicações, taxas de mortalidade e de sobrevida. De acordo com eles, apesar de haver consenso em relação à necessidade de tratamento operatório rápido, não o há para a técnica que deve ser usada nesses casos (Han et al, 2013).…”

Section: Reconstrução Reforçada De Raiz Aórtica Para Dissecção Aórtica Tipo a Envolvendo A Raiz Aórticaunclassified

“…Além disso, as taxas de mortalidade hospitalar (6,2%) e de acompanhamento (6,8%), que ocorreu por um período de 2 a 12 anos, não se mostraram mais altas do que aquelas visualizadas em estudos já publicados relacionados às técnicas cirúrgicas previamente adotadas para esses casos. Contudo, há a limitação de ser um estudo retrospectivo sem outro grupo para comparação (Han et al, 2013).…”

Section: Reconstrução Reforçada De Raiz Aórtica Para Dissecção Aórtica Tipo a Envolvendo A Raiz Aórticaunclassified

Evolução e qualidade de vida em pós-operatório de cirurgia vascular

Mendes¹,

Araújo²,

Lima³

et al. 2021

RSD

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Este estudo tem como objetivo analisar e avaliar a qualidade de vida na recuperação de pacientes no período de pós-operatório em cirurgias vasculares. Métodos: trata-se de uma revisão de literatura integrativa, a qual se realizou uma pesquisa bibliográfica nas seguintes bases de dados, selecionadas através do metabuscador do Portal Periódico CAPES: Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrievel System Online (Medline) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), utilizando os descritores “Cirurgia vascular”, “Pós-operatório” e “Qualidade de vida”, que foram pesquisados nos Descritores em Ciências da Saúde (DECs). Após a leitura analítica, apenas 14 artigos atenderam aos critérios de inclusão e foram utilizados para compor a amostra final deste estudo. Foram utilizados os artigos que estivessem enquadrados como estudos com seres humanos e publicados entre 2010 e 2020. Resultados: a técnica cirúrgica tem grande influência na evolução do quadro clínico do paciente. Novas técnicas surgem com o objetivo de ser menos invasivas e proporcionarem uma melhor recuperação. Porém, algumas patologias, por serem graves, ainda apresentam uma alta taxa de mortalidade e complicações. Conclusão: Pacientes acometidos por doenças vasculares necessitam de um cuidado especial no intuito de evitar complicações no pós-operatório e garantir uma boa qualidade de vida. Observou-se que além da gravidade da doença, a avaliação da realidade que o paciente está inserido tem importância considerável na qualidade de vida, uma vez que os fatores biopsicossociais impactam de forma significativa no processo de adoecimento.

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Predictors of Outcomes after Correction of Acute Type A Aortic Dissection under Moderate Hypothermic Circulatory Arrest and Antegrade Cerebral Perfusion

Samanidis¹,

Katselis²,

Contrafouris³

et al. 2018

Braz J Cardiovasc Surg

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IntroductionHypothermic circulatory arrest is widely used for correction of acute type A aortic dissection pathology. We present our experience of 45 consecutive patients operated in our unit with bilateral antegrade cerebral perfusion and moderate hypothermic circulatory arrest.MethodsBetween January 2011 and April 2015, 45 consecutive patients were admitted for acute type A aortic dissection and operated emergently under moderate hypothermic circulatory arrest and bilateral antegrade cerebral perfusion. ResultsMean age was 58±11.4 years old. Median circulatory arrest time was 41.5 (30-54) minutes while the 30-day mortality and postoperative permanent neurological deficits rates were 6.7% and 13.3%, respectively. Unadjusted analysis revealed that the factors associated with 30-day mortality were: preoperative hemodynamic instability (OR: 14.8, 95% CI: 2.41, 90.6, P=0.004); and postoperative requirement for open sternum management (OR: 5.0, 95% CI: 1.041, 24.02, P=0.044) while preoperative hemodynamic instability (OR: 8.8, 95% CI: 1.41, 54.9, P=0.02) and postoperative sepsis or multiple organ dysfunction (OR: 13.6, 95% CI: 2.1, 89.9, P=0.007) were correlated with neurological dysfunction. By multivariable logistic regression analysis, postoperative sepsis and multiple organ dysfunction independently predicted (OR: 15.9, 95% CI: 1.05, 96.4, P=0.045) the incidence of severe postoperative neurological complication. During median follow-up of 6 (2-12) months, the survival rate was 86.7%.ConclusionBilateral antegrade cerebral perfusion and direct carotid perfusion for cardiopulmonary bypass, in the surgical treatment for correction of acute aortic dissection type A, is a valuable technique with low 30-day mortality rate. However, postoperative severe neurological dysfunctions remain an issue that warrants further research.

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Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root

Abstract: This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.

Cited by 3 publications

References 16 publications

Reinforced Aortic Root Reconstruction in Type A Aortic Dissection: A Prospective Study

Reinforced Aortic Root Reconstruction in Type A Aortic Dissection: A Prospective Study

Evolução e qualidade de vida em pós-operatório de cirurgia vascular

Predictors of Outcomes after Correction of Acute Type A Aortic Dissection under Moderate Hypothermic Circulatory Arrest and Antegrade Cerebral Perfusion

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