Axillary Cannulation for Surgical Repair for Acute Stanford A Aortic Dissection: Long-term Survival and Freedom from Major Cerebrovascular Events with up to 10-year Follow-up

Sabashnikov, Anton; Heinen, Stephanie; Eghbalzadeh, Kaveh; Zeriouh, Mohamed; Slottosch, Ingo; Liakopoulos, OJ; Kroener, Axel; Rahmanian, Parwis B.; Madershahian, Navid; Choi, Yoon Hong; Kuhn‐Régnier, Ferdinand; Wippermann, Jens; Wahlers, T

doi:10.1055/s-0036-1571649

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“…According to 2016 data from the world's largest International Registry of Acute AD (IRAD), the early mortality rate of patients with acute AD is still 17%-26%, which means that under existing medical methods, even after the most complex surgical treatment, patients have a very high risk of death, so the strategy optimization of each treatment link cannot be underestimated [14]. Te pathological manifestations are aortic intima tear, intima rupture, aortic nutrient vessel rupture, and media hemorrhage caused by many reasons.…”

Section: Discussionmentioning

confidence: 99%

A Cohort Study of Surgical Indexes, Postoperative Complications, Recovery Speed, and Prognosis of Stanford Type A Aortic Dissection Compared with Traditional Sun’s Operation

Feng

Ren

Zhang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. The objective is to explore the surgical index, postoperative complications, recovery speed, and prognosis of Stanford type A aortic dissection (AD) compared with traditional ’Sun’s operation. Methods. One hundred patients with Stanford type A AD treated from February 2018 to February 2021 were enrolled in our hospital. Patients were randomly divided into control and research group. The former group underwent traditional Sun’s surgery, and the latter group underwent combined debranching surgery. The general data, surgical indexes, total amount of blood transfusion, renal function 72 hours after operation, postoperative indexes during hospitalization, and follow-up results after discharge were compared between the two groups. Results. The CPB time, ACC time, operation time, and postoperative total drainage volume of the study group were all lower than those of the control group, and the intraoperative urine volume of the study group was higher than that of the control group ( P < 0.05 ). The total amount of RBC infused in the study group was higher than that in the control group, while the total amount of PLT, cryoprecipitate, and plasma infusion in the study group was lower than that in the control group ( P < 0.05 ). At 72 hours after operation, BUN, Scr, and UA in the study group were significantly lower than those in the control group ( P < 0.05 ). The number of the secondary intubation, hemodialysis, neurological complications, and deaths in the study group was significantly lower than that in the control group ( P < 0.05 ). Conclusion. Both Sun’s operation and branch removal are more effective treatment methods, and the two different surgical methods have different indications, advantages, and disadvantages, so different surgical methods can be chosen according to different conditions for Stanford AD. The possible postoperative complications should be comprehensively analyzed in the clinical work in order to reduce the occurrence of postoperative complications and improve the cure rate.

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Section: Discussionmentioning

confidence: 99%