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. 2021 Jul 14:14:3013-3023.
doi: 10.2147/RMHP.S296165. eCollection 2021.

Clinical Efficacy of Hybrid Surgery for Stanford Type A Aortic Dissection

Jianjun Gu  1 , Ziying Chen  1
Affiliations

Clinical Efficacy of Hybrid Surgery for Stanford Type A Aortic Dissection

Jianjun Gu et al. Risk Manag Healthc Policy. .

Abstract

Introduction: To evaluate the clinical efficacy of hybrid surgery for Stanford type A aortic dissection.

Methods: Twenty-two patients with Stanford type A aortic dissection were selected. All patients had completed or undergone hybrid surgery, including extracorporeal circulation, treatment of proximal anastomosis of ascending aorta and the distal anastomosis of the ascending aorta, management of the branch vessels on the arch, aortic endovascular repair. This study analyzed the time of surgery and awake, blood transfusion during surgery, patient's drainage, complications and CTA of aorta was re-examined about one month after operation during patients follow-up.

Results: All patients underwent the operation successfully. One patient died of renal failure after the operation. Two patients experienced postoperative neurological complications (anxiety and delirium). Renal function was abnormal in two patients, and one patient needed bedside blood filtration. The serum creatinine levels temporarily increased in seven patients. No stent migration was found during patient follow-up. There was no shift in the stents. The near end of the interlayer was well sealed, without leakage of contrast agent, and the false lumen near the stent was completely thrombosed. Compared with the pre-operative CTA, the true lumen was enlarged and the false lumen was reduced, and the false lumen was completely thrombosed in the proximal end and near the stent. Contrast media was seen in the false lumen.

Conclusion: One-stage hybrid surgery for Stanford type A aortic dissection can avoid deep hypothermic circulatory arrest, shorten operation time, reduce operation trauma, and reduce the incidence of postoperative complications. This treatment has a effective treatment effect in the short term. However, the limitations imposed by covered stent materials mean that the treatment's long-term effect is not yet clear, and further research is needed.

Keywords: Stanford type A; aortic dissection; ascending aorta; one-stage hybrid surgery; postoperative complications.

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Conflict of interest statement

All of the authors had no any personal, financial, commercial, or academic conflicts of interest separately.

Figures

Figure 1
Figure 1
Preoperative photos and descriptions.
Figure 2
Figure 2
Operative photos.
Figure 3
Figure 3
Postoperative photos 1–2.
Figure 4
Figure 4
Postoperative photos 3.
Figure 5
Figure 5
Postoperative photos 4.
See this image and copyright information in PMC

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