Dacron Graft Intussusception Technique for Treatment of Type A Aortic Dissections: Technical Notes and Preliminary Results

Pinheiro, Bruno Botelho; Fagundes, Walter Vosgrau; Muniz, Luis; Dreifaldt, Mats; Arbeus, Mikael; Souza, Domingos

doi:10.5935/1678-9741.20160042

Cited by 2 publications

(4 citation statements)

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“…Although the amount of drainage was relatively higher in the Teflon group, there was no statistically significant difference between the two groups in terms of amount of drainage and revision rate. The amount of drainage in both groups was similar to or less than the literature [10,11,[14][15][16][17][18][19].…”

Section: Discussionsupporting

confidence: 77%

“…These are anastomosis techniques to reinforce a suture line, glues for anastomosis or wrapping methods. A new method used for reducing bleeding in the anastomotic line is the Dacron graft intussusception technique described by Pinheiro et al [18]. The common goal of all these techniques is to create a more secure anastomosis and to reduce surgical bleeding [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…A new method used for reducing bleeding in the anastomotic line is the Dacron graft intussusception technique described by Pinheiro et al [18]. The common goal of all these techniques is to create a more secure anastomosis and to reduce surgical bleeding [17,18]. In a case-series study of Pinheiro BB et al [18], it was found that the mean amount of postoperative bleeding was 654 ml and that the revision rate due to bleeding was 4.1%.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the results of Teflon felt and Dacron strip usage in Stanford type A dissection

Demir

Kahraman

2019

The European Research Journal

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Objectives: In patients who undergo surgery for aortic dissection, the anastomotic leakage and the bleeding in these regions affect surgical success and mortality rate significantly. Various surgical materials are used for this purpose. We examined the results obtained from patients in whom Teflon felt strip or Dacron strip was used for creating a more secure anastomotic suture line. Methods: Twenty-eight patients who underwent surgery for ascending aortic dissection between 2013 and 2017 were examined retrospectively. Teflon felt strip or Dacron strip was used to create a more secure anastomotic suture line and to reduce bleeding in these patients. The patients were divided into the Teflon and Dacron groups according to the materials used. The amount of drainage, the amount of tissue adhesive used, the number of red blood cell (RBC) transfusions, and the morbidity and mortality rates were mainly compared between the two groups. Results: While Teflon felt strip was used in 13 (46%) patients, Dacron strip was used in 15 (53%) patients. The mean amount of drainage in the first 24 hours postoperatively was 596.15 ± 165.15 ml in the Teflon group and 546.67 ± 217.5 ml in the Dacron group. There was no statistically significant difference between the two groups in terms of mean amount of drainage (p = 0.509). Similarly, the mean number of RBC transfusions was 2.54 ± 0.51 units in the Teflon group and 2.33 ± 0.81 units in the Dacron group. There was no statistically significant difference between the two groups in terms of mean number of RBC transfusions (p = 0.416). Although the mean amount of tissue adhesive used was relatively higher in the Dacron group, there was no statistically significant difference between the two groups in terms of mean amount of tissue adhesive used (p = 0.761). The total mortality rate was 28% (8 patients). There was no statistically significant difference between the two groups in terms of mortality rate (p = 0.281). Conclusion: We concluded that the results obtained from the Teflon and Dacron groups were not significantly superior to each other. We think that Dacron strip may be used as an alternative to Teflon felt strip, which is used routinely in the surgical treatment of aortic dissection.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of the results of Teflon felt and Dacron strip usage in Stanford type A dissection

Demir

Kahraman

2019

The European Research Journal

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“…Publications of series on operations in the ascending aorta and hemiarch continue to discuss advantages and disadvantages amongst different techniques particularly in AAD pathology [ 1 - 7 ] . However, there is unanimity in that the most significant concern during this type of operations is the protection of the central nervous system (CNS) during the interval of hypothermic CA.…”

Section: Discussionmentioning

confidence: 99%

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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Dacron Graft Intussusception Technique for Treatment of Type A Aortic Dissections: Technical Notes and Preliminary Results

Cited by 2 publications

References 20 publications

Comparison of the results of Teflon felt and Dacron strip usage in Stanford type A dissection

Comparison of the results of Teflon felt and Dacron strip usage in Stanford type A dissection

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

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