The effect of Cabrol in treatment of Stanford type A aortic dissection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 YANG Jianguo , ZHAO Jinping , XU Ming , ZHANG li

Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430070, P.R.China;

Corresponding author：

YANG Jianguo, Email: 979638260@qq.com

Keywords：

Cabrol’s operation; Stanford type A aortic dissection; effect evaluation

DOI：

10.7507/1007-4848.201810007

Video：

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Objective To discuss the effect of Cabrol in treatment of Stanford type A aortic dissection.Methods The clinical data of patients whom were diagnosed with type A aortic dissection of Stanford in our hospital from January 2013 to January 2018 were retrospectively analyzed. All of 40 patients underwent Cabrol surgical procedure. There were 31 males and 9 females aged 26–75 (48.8±3.3) years. The surgical treatment effect of the patients was evaluated, mainly including the aortic index, the changes in cardiac function before and after operation, and the postoperative follow-up.Results All the 40 patients completed the operation successfully. The diameter of ascending aorta and aortic sinus in postoperative patients were smaller than those before operation (P<0.05). Postoperative left ventricular ejection fraction and cardiac output increased, central venous pressure and left ventricular end-diastolic dimension decreased, and cardiac function indexes were significantly different from those before the operation (P<0.05). Seven patients suffered complications in postoperative follow-up including one stenting leakage, three neurological diseases and three acute renal failure. Two patients died postoperatively.Conclusion Cabrol’s operation is effective in the treatment of Stanford type A aortic dissection, which can significantly improve the cardiac function of patients, simplify the anastomosis of coronary artery ostia and decrease amount of bleeding.

Citation： YANG Jianguo, ZHAO Jinping, XU Ming, ZHANG li. The effect of Cabrol in treatment of Stanford type A aortic dissection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(7): 670-673. doi: 10.7507/1007-4848.201810007 Copy

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2.	Ohlmann P, Faure A, Morel O, et al. Diagnostic and prognostic value of circulating D-Dimers in patients with acute aortic dissection. Crit Care Med, 2006, 34(5): 1358-1364.
3.	Golledge J, Eagle KA. Acute aortic dissection. Lancet, 2008, 372(9632): 55-66.
4.	Isselbacher EM, Chief editor. Epidemiology of thoracic aortic aneurysms, aortic dissection, intramular hematnma, and penetrating atherosclerotic ulcers. Baliga RR, Nienaber CA, lsselbacher EM, et al, ed. Aortic Dissection and Related Syndromes. New York: Springer Science, 2007. 3-15.
5.	Luo F, Zhou XL, Li JJ, et al. Inflammatory response is associated with aortic dissection. Ageing Res Rev, 2009, 8: 31-35.
6.	Sun L, Qi R, Chang Q, et al. Surgery for Marfan patients with acute type a dissection using a stented elephant trunk procedure. Ann Thorac Surg, 2008, 86(6): 1821-1825.
7.	李滨, 孙立忠, 常谦, 等. 全弓替换加支架象鼻技术治疗复杂 Standford B 型主动脉夹层的临床观察. 中华医学杂志, 2010, 90(5): 323-326.
8.	Sun L, Zhao X, Chang Q, et al. Repair of chronic type B dissection with aortic arch involvement using a stented elephant trunk procedure. Ann Thorac Surg, 2010, 90(1): 95-100.
9.	Zhao HP, Zhu JM, Ma WG, et al. Total arch replacement with stented elephant trunk technique for acute type B aortic dissection involving the aortic arch. Ann Thorac Surg, 2012, 93(5): 1517-1522.
10.	Sun L, Qi R, Zhu J, et al. Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch? Circulation, 2011, 123(9): 971-978.
11.	庞锋, 陈兴澎. 支架象鼻开窗简化手术在治疗急性 Stanford A 型主动脉夹层中的临床分析. 中国心血管病研究, 2017, 15(11): 999-1001.
12.	孙祥飞, 孙文宇, 霍玉峰, 等. 改良 Y 型人工血管技术治疗急性 Stanford A 型主动脉夹层的短期疗效观察. 世界最新医学信息文摘, 2018, 18(16): 77-178, 180.
13.	吴怡锦, 熊卫萍, 曾嵘, 等. 孙氏手术治疗急、慢性 Stanford A 型主动脉夹层疗效的病例对照研究. 中国胸心血管外科临床杂志, 2018, 25(5): 401-405.
14.	程凤, 陈庆良, 姜楠, 等. 孙氏手术与三分支主动脉弓覆膜支架治疗 Stanford A 型主动脉夹层的效果比较. 天津医药, 2016, 44(8): 951-954.
15.	熊师, 公兵, 田聪聪, 等. 三分支支架治疗急性 Stanford A 型主动脉夹层疗效的临床研究. 中国循环杂志, 2017, 32(s1): 147.
16.	潘俊, 宣煜龙, 陈小芳, 等. 孙氏手术治疗急性 Stanford A 型主动脉夹层. 中华胸心血管外科杂志, 2015, 31(6): 333-335.
17.	吴玉辉, 江蕊, 江磊, 等. 88 例 Stanford A 型主动脉夹层外科治疗效果. 临床军医杂志, 2017, 24(11): 1149-1152.
18.	李欣, 范瑞新, 张洪宇, 等. Cabrol 手术应用于 Stanford A 型主动脉夹层的疗效分析. 中国胸心血管外科临床杂志, 2015, 22(3): 198-201.
19.	Ghazy T, Eraqi M, Mahlmann A, et al. Quality of life after surgery for Stanford type A aortic dissection: influences of different operative strategies. Heart Surg Forum, 2017, 20(3): E102-E106.
20.	Cheng Y, Jin M, Dong X, et al. Mechanism and early intervention research on ALI during emergence surgery of Stanford type-A AAD: Study protocol for a prospective, double-blind, clinical trial. Medicine (Baltimore), 2016, 95(42): e5164.

1. Patel HJ, Deeb GM. Ascending and arch aorta: pathology, natural history, and treatment. Circulation, 2008, 118(2): 188-195.
2. Ohlmann P, Faure A, Morel O, et al. Diagnostic and prognostic value of circulating D-Dimers in patients with acute aortic dissection. Crit Care Med, 2006, 34(5): 1358-1364.
3. Golledge J, Eagle KA. Acute aortic dissection. Lancet, 2008, 372(9632): 55-66.
4. Isselbacher EM, Chief editor. Epidemiology of thoracic aortic aneurysms, aortic dissection, intramular hematnma, and penetrating atherosclerotic ulcers. Baliga RR, Nienaber CA, lsselbacher EM, et al, ed. Aortic Dissection and Related Syndromes. New York: Springer Science, 2007. 3-15.
5. Luo F, Zhou XL, Li JJ, et al. Inflammatory response is associated with aortic dissection. Ageing Res Rev, 2009, 8: 31-35.
6. Sun L, Qi R, Chang Q, et al. Surgery for Marfan patients with acute type a dissection using a stented elephant trunk procedure. Ann Thorac Surg, 2008, 86(6): 1821-1825.
7. 李滨, 孙立忠, 常谦, 等. 全弓替换加支架象鼻技术治疗复杂 Standford B 型主动脉夹层的临床观察. 中华医学杂志, 2010, 90(5): 323-326.
8. Sun L, Zhao X, Chang Q, et al. Repair of chronic type B dissection with aortic arch involvement using a stented elephant trunk procedure. Ann Thorac Surg, 2010, 90(1): 95-100.
9. Zhao HP, Zhu JM, Ma WG, et al. Total arch replacement with stented elephant trunk technique for acute type B aortic dissection involving the aortic arch. Ann Thorac Surg, 2012, 93(5): 1517-1522.
10. Sun L, Qi R, Zhu J, et al. Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch? Circulation, 2011, 123(9): 971-978.
11. 庞锋, 陈兴澎. 支架象鼻开窗简化手术在治疗急性 Stanford A 型主动脉夹层中的临床分析. 中国心血管病研究, 2017, 15(11): 999-1001.
12. 孙祥飞, 孙文宇, 霍玉峰, 等. 改良 Y 型人工血管技术治疗急性 Stanford A 型主动脉夹层的短期疗效观察. 世界最新医学信息文摘, 2018, 18(16): 77-178, 180.
13. 吴怡锦, 熊卫萍, 曾嵘, 等. 孙氏手术治疗急、慢性 Stanford A 型主动脉夹层疗效的病例对照研究. 中国胸心血管外科临床杂志, 2018, 25(5): 401-405.
14. 程凤, 陈庆良, 姜楠, 等. 孙氏手术与三分支主动脉弓覆膜支架治疗 Stanford A 型主动脉夹层的效果比较. 天津医药, 2016, 44(8): 951-954.
15. 熊师, 公兵, 田聪聪, 等. 三分支支架治疗急性 Stanford A 型主动脉夹层疗效的临床研究. 中国循环杂志, 2017, 32(s1): 147.
16. 潘俊, 宣煜龙, 陈小芳, 等. 孙氏手术治疗急性 Stanford A 型主动脉夹层. 中华胸心血管外科杂志, 2015, 31(6): 333-335.
17. 吴玉辉, 江蕊, 江磊, 等. 88 例 Stanford A 型主动脉夹层外科治疗效果. 临床军医杂志, 2017, 24(11): 1149-1152.
18. 李欣, 范瑞新, 张洪宇, 等. Cabrol 手术应用于 Stanford A 型主动脉夹层的疗效分析. 中国胸心血管外科临床杂志, 2015, 22(3): 198-201.
19. Ghazy T, Eraqi M, Mahlmann A, et al. Quality of life after surgery for Stanford type A aortic dissection: influences of different operative strategies. Heart Surg Forum, 2017, 20(3): E102-E106.
20. Cheng Y, Jin M, Dong X, et al. Mechanism and early intervention research on ALI during emergence surgery of Stanford type-A AAD: Study protocol for a prospective, double-blind, clinical trial. Medicine (Baltimore), 2016, 95(42): e5164.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The effect of Cabrol in treatment of Stanford type A aortic dissection

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