Surgical Treatment for Patients with Stanford Type A Aortic Dissection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIAOYi-min ,  XIAOMing-di , WANGLian-cai , CHENGChang

Department of Cardiovascular Surgery, Shanghai Yuanda Heart Hospital, Shanghai 200315, P. R. China;

Corresponding author：

XIAOMing-di, Email: xymshow@hotmail.com

Keywords：

Stanford type A aortic dissection; Surgery; Mortality; Complication

DOI：

10.7507/1007-4848.20140099

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize our clinical experience of surgical treatment for 51 patients with Stanford type A aortic dissection (AD). Methods Clinical data of 51 patients with Stanford type A AD who received surgical treatment in Shanghai Yuanda Heart Hospital between February 2009 and January 2013 were retrospectively analyzed. There were 29 males and 22 females with their age of 35-63 (47.2±11.1)years. The diagnosis of all the patients was confirmed by enhanced CT scan and Doppler echocardiography. Surgical procedures included Bentall procedure and Sun's procedure in 29 patients, Bentall procedure, mitral valve replacement and Sun's procedure in 2 patients, ascending aorta replacement and Sun's procedure in 17 patients, valsalva sinus plasty, ascending aorta replacement and Sun's procedure in 2 patients, ascending aorta replacement (stage 1), Sun's procedure (stage 2)and endovascular exclusion of the thoracic aorta (stage 3)in 1 patient. Results Mean operation time was 320.6±77.3 minutes, cardiopulmonary bypass time was 190.4±63.4 minutes, aortic cross-clamp time was 123.2±45.1 minutes, duration of circulatory arrest with hypothermia was 28.2±11.1 minutes, and mean length of hospital stay was 13.4±4.2 days. Two patients (3.9%)died perioperatively including 1 patient with intraoperative bleeding and another patient with delayed bleeding after operation. Postoperative complications included bleeding, paraplegia, perivalvular leak and sternal dehiscence in 1 patient respectively, and endoleak in 2 patients. Forty-nine patients were followed up for 3-48 (25.3±10.5)months and no late death occurred. Conclusion Surgical treatment is effective for patients with Stanford type A AD.

Citation： XIAOYi-min, XIAOMing-di, WANGLian-cai, CHENGChang. Surgical Treatment for Patients with Stanford Type A Aortic Dissection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(3): 361-363. doi: 10.7507/1007-4848.20140099 Copy

1.	孙立忠, 刘宁宁, 常谦, 等.主动脉夹层的细化分型及其应用.中华外科杂志, 2005, 43 (18):49-55.
2.	Perreas K, Samanidis G, Dimitriou S, et al. Outcomes after ascending aorta and proximal aortic arch repair using deep hypothermic circula-tory arrest with retrograde cerebral perfusion:analysis of 207 patients. Interact Cardiovasc Thorac Surg, 2012, 15 (3):456-461.
3.	张力, 王平凡, 梁志强, 等. 201例Stanford A型主动脉夹层的外科治疗.中国综合临床, 2012, 28 (4):418-421.
4.	孙立忠, 刘志刚, 常谦, 等.主动脉弓替换加支架"象鼻"手术治疗Stanford A型主动脉夹层.中华外科杂志, 2004, 42 (13):812-816.
5.	Minami T, Imoto K, Uchida K, et al. Clinical outcomes of emergency surgery for acute type B aortic dissection with rupture. Eur J Cardiothorac Surg, 2013, 44 (2):360-364.
6.	Ryckwaer F, Colson P, Ribstein J, et al. Haemodynamic and renal effects of intravenous enalaprilat during coronary artery bypass graft surgery in patients with ischaemic heart dysfuntion. Br J Anaesth, 2001, 86 (2):169-175.
7.	Elalamy I, Lecrubier C, Horellou MH, et al. Heparin-induced thrombocytopenia:laboratory diagnosis and management. Ann Med, 2000, 32 (Suppl 1):60-67.
8.	Lubenow N, Greinacher A. Management of patient with pathobiology of heparin-induced thrombocytopenia:focus on recombinant hirudin. J Thromb Thrombolysis, 2000, 10:S47-S57.
9.	Krähenbühl ES, Immer FF, Stalder M, et al. Temporary neurological dysfuction after surgery of the thoracic aorta:a predictor of poor outcome and impaired quality of life. Eur J Cardiothorac Surg, 2008, 33 (6):1025-1029.
10.	Pacini D, Di Marco I, Leone A, et al. Cerebral functions and metab-olism after antegrade selective cerebral perfusion in aortic arch surgery. Eur J Cardiothorac Surg, 2010, 37 (6):1322-1331.
11.	尚蔚, 刘楠, 闫晓蕾, 等. A型主动脉夹层手术后早期并发症分析.心肺血管病杂志, 2011, 30 (3):183-186.
12.	Szeto WY, Desai ND, Moeller P, et al. Reintervention for endograft failures after thoracic endovascular aortic repair. J Thorac Cardiovasc Surg, 2013, 145 (3 Suppl):S165-S170.
13.	黄连军, 孙立忠, 朱俊民, 等.覆膜血管内支架种植治疗B型主动脉夹层.医学研究杂志, 2006, 35 (1):18-20.
14.	马黎明, 褚衍林, 乔衍礼, 等.急诊心脏瓣膜替换25例报告.心肺血管病杂志, 2010, 29 (1):15-18.
15.	张宝仁, 徐志云, 邹良建, 等.人工心脏瓣膜置换术后63例瓣周漏的外科治疗.中国胸心血管外科临床杂志, 2007, 14 (2):81-84.

1. 孙立忠, 刘宁宁, 常谦, 等.主动脉夹层的细化分型及其应用.中华外科杂志, 2005, 43 (18):49-55.
2. Perreas K, Samanidis G, Dimitriou S, et al. Outcomes after ascending aorta and proximal aortic arch repair using deep hypothermic circula-tory arrest with retrograde cerebral perfusion:analysis of 207 patients. Interact Cardiovasc Thorac Surg, 2012, 15 (3):456-461.
3. 张力, 王平凡, 梁志强, 等. 201例Stanford A型主动脉夹层的外科治疗.中国综合临床, 2012, 28 (4):418-421.
4. 孙立忠, 刘志刚, 常谦, 等.主动脉弓替换加支架"象鼻"手术治疗Stanford A型主动脉夹层.中华外科杂志, 2004, 42 (13):812-816.
5. Minami T, Imoto K, Uchida K, et al. Clinical outcomes of emergency surgery for acute type B aortic dissection with rupture. Eur J Cardiothorac Surg, 2013, 44 (2):360-364.
6. Ryckwaer F, Colson P, Ribstein J, et al. Haemodynamic and renal effects of intravenous enalaprilat during coronary artery bypass graft surgery in patients with ischaemic heart dysfuntion. Br J Anaesth, 2001, 86 (2):169-175.
7. Elalamy I, Lecrubier C, Horellou MH, et al. Heparin-induced thrombocytopenia:laboratory diagnosis and management. Ann Med, 2000, 32 (Suppl 1):60-67.
8. Lubenow N, Greinacher A. Management of patient with pathobiology of heparin-induced thrombocytopenia:focus on recombinant hirudin. J Thromb Thrombolysis, 2000, 10:S47-S57.
9. Krähenbühl ES, Immer FF, Stalder M, et al. Temporary neurological dysfuction after surgery of the thoracic aorta:a predictor of poor outcome and impaired quality of life. Eur J Cardiothorac Surg, 2008, 33 (6):1025-1029.
10. Pacini D, Di Marco I, Leone A, et al. Cerebral functions and metab-olism after antegrade selective cerebral perfusion in aortic arch surgery. Eur J Cardiothorac Surg, 2010, 37 (6):1322-1331.
11. 尚蔚, 刘楠, 闫晓蕾, 等. A型主动脉夹层手术后早期并发症分析.心肺血管病杂志, 2011, 30 (3):183-186.
12. Szeto WY, Desai ND, Moeller P, et al. Reintervention for endograft failures after thoracic endovascular aortic repair. J Thorac Cardiovasc Surg, 2013, 145 (3 Suppl):S165-S170.
13. 黄连军, 孙立忠, 朱俊民, 等.覆膜血管内支架种植治疗B型主动脉夹层.医学研究杂志, 2006, 35 (1):18-20.
14. 马黎明, 褚衍林, 乔衍礼, 等.急诊心脏瓣膜替换25例报告.心肺血管病杂志, 2010, 29 (1):15-18.
15. 张宝仁, 徐志云, 邹良建, 等.人工心脏瓣膜置换术后63例瓣周漏的外科治疗.中国胸心血管外科临床杂志, 2007, 14 (2):81-84.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical Treatment for Patients with Stanford Type A Aortic Dissection

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content