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[Surgical management for Stanford A aortic dissection].

Si-hong Zheng1, Yan-qing Sun, Xu Meng

  • 1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China. zhengsihong1962@yahoo.com.cn

Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|November 8, 2005
PubMed
Summary

This study reviewed 68 Stanford A aortic dissection surgeries. Key factors for successful aortic dissection surgery include proper surgical indication, technique, and brain protection strategies.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Context:

  • Stanford A aortic dissection is a life-threatening condition requiring complex surgical intervention.
  • Surgical management has evolved with advancements in cardiopulmonary bypass and cerebral protection techniques.
  • Understanding surgical outcomes is crucial for optimizing patient care.

Purpose:

  • To summarize the surgical experience and outcomes for patients with Stanford A aortic dissection.
  • To evaluate the impact of different surgical techniques and cerebral protection strategies.
  • To identify key factors influencing surgical success in aortic dissection repair.

Summary:

  • Sixty-eight patients with Stanford A aortic dissection underwent surgery between 1998 and 2004.

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  • Various surgical approaches were employed, including ascending aorta grafting, hemiarch, and total arch replacement, with or without the Frozen elephant trunk procedure.
  • Cerebral protection strategies included moderate hypothermic cardiopulmonary bypass, deep hypothermic circulatory arrest with retrograde or antegrade cerebral perfusion.

    • Impact:

    • The study reports an overall operative mortality of 7%, with urgent surgery mortality at 8% and elective at 7%.
    • Long-term follow-up demonstrated excellent actuarial survival rates: 100% at 1 year, 95% at 3 years, and 86% at 5 years.
    • The findings underscore the importance of tailored surgical procedures based on intimal tear location and emphasize the critical role of surgical technique and brain protection in achieving favorable outcomes for Stanford A aortic dissection.