Related Experiment Video

Updated: Aug 26, 2025

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

449

Outcomes of surgical treatment on type A acute aortic dissection accompanied with coronary artery involvement

Wei Qin1, Rui Fan2, Jiankai Wang1

  • 1Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Frontiers in Surgery
|October 13, 2022
PubMed

Insights

Coronary artery bypass grafting (CABG) and local coronary repair offer similar long-term survival for type A acute aortic dissection (AAD) patients with coronary artery involvement. These surgical strategies effectively manage blood flow restoration in complex cardiovascular cases.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Acute aortic dissection (AAD) involving coronary arteries (CA) presents a high mortality risk.
  • Surgical repair of the aorta requires strategies to restore CA blood flow.
  • Coronary artery bypass grafting (CABG) and local coronary repair are primary surgical options.

Purpose of the Study:

  • To compare operative and long-term outcomes of CABG versus local coronary repair in type A AAD patients with CA involvement.
  • Evaluate the effectiveness of different surgical approaches for managing coronary complications during aortic repair.

Main Methods:

  • Retrospective review of 148 type A AAD patients with CA involvement (2001-2021).
  • Patients underwent either aortic repair with concomitant CABG (Group I) or local coronary repair (Group II).
  • Comparison of perioperative complications, hospital mortality, and long-term survival rates.

Main Results:

  • Group I (CABG) had more patients with acute myocardial ischemia and complex CA lesions (types B/C) than Group II (local repair).
  • Postoperative acute kidney injury was significantly higher in Group I (34.5%) compared to Group II (8.9%).
  • Hospital mortality and long-term survival rates showed no statistically significant difference between the groups.

Conclusions:

  • Both CABG and local coronary repair are viable options for type A AAD with CA involvement.
  • The choice of strategy should consider the specific type of CA involvement.
  • Both approaches yield comparable long-term survival outcomes.
Abstract

Keywords:
acute aortic dissectioncoronary artery bypass graftingcoronary artery involvementlocal coronary repairsurgical outcomessurvival rate

More Related Videos

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.2K
Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

Published on: April 24, 2017

18.6K

Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
17
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
33
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
16
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
23
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
25
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
46