Transverse Pericardial Sinus Closure in Acute Type A Aortic Dissection Operation

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Device Technology

Background:

• Acute type A aortic dissection requires complex surgical intervention.
• Elderly patients and those on anticoagulation present unique challenges in managing intraoperative bleeding.
• Traditional surgical approaches may struggle with diffuse suture line oozing in these patient populations.

Purpose of the Study:

• To describe a technique for prophylactic transverse pericardial sinus closure.
• To evaluate the utility of this closure for autotransfusion of blood loss.
• To address challenges in managing bleeding during aortic dissection repair in high-risk patients.

Main Methods:

• Routine closure of the transverse pericardial sinus before graft implantation in open-heart surgery for acute type A aortic dissection.
• Utilizing a bovine pericardial patch to cover the pericardial recess.
• Creating an opening in the superior caval vein for central venous access.

Main Results:

• The described closure technique facilitates autotransfusion of blood loss into the central venous system.
• This method effectively manages diffuse oozing from the suture line.
• The technique is applicable in elderly patients and those on long-term anticoagulation.

Conclusions:

• Prophylactic transverse pericardial sinus closure is a valuable adjunct in managing bleeding during aortic dissection surgery.
• This technique enables effective autotransfusion, particularly in high-risk patient groups.
• The described method offers a solution for diffuse suture line oozing, potentially improving patient outcomes.