Tianjin Med J ›› 2016, Vol. 44 ›› Issue (8): 951-954.doi: 10.11958/20150247

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A comparison of Sun’ s operation and ascending aorta replacement combined with open placement of triple-branched stent graft in treatment of type A aortic dissection

CHENG Feng1 , CHEN Qingliang2△, JIANG Nan2 , CHEN Tongyun2 , ZHAO Feng2   

  1. 1 Tianjin Medical University, Tianjin 300070, China; 2 Tianjin Chest Hospital
  • Received:2015-10-20 Revised:2016-02-05 Published:2016-08-15 Online:2016-08-22
  • Contact: CHEN Qingliang E-mail: woshidachengzi@Foxmail.com E-mail:qingliang1971@126.com

Abstract: Abstract: Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’ s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’ s operation group (n=22) and triple branches aortic arch stent-graft placement op⁃ eration (triple- branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera⁃ tive death in Sun’ s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’ s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’ s group [(50.9±6.9) mm vs. (55.0±7.5) mm, (28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame⁃ ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv⁃ al curve showed that five-year survival rate of Sun’ s group was similar with that of triple-branched group (Log-rank χ2 = 0.095, P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’ s group and triple-branched group (P>0.05). Conclusion Sun’ s operation can significantly decrease patient’ s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.

Key words:  aortic diseases, operation, treatment outcome, Sun&rsquo, s operation, open placement of triple-branched stent graft, aortic dissection