Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• Acute Stanford type A aortic dissection (STAAD) is a life-threatening condition necessitating immediate surgical treatment.
• Surgical complexity in STAAD often leads to complications, including neurological deficits.
• This study examines the impact of prioritizing aortic arch branch reconstruction on patient outcomes in STAAD surgery.

Purpose of the Study:

• To investigate the association between prioritizing aortic arch branch reconstruction and postoperative outcomes in patients with STAAD.
• To compare the efficacy of the branch-priority technique versus the classic technique in STAAD surgery.

Main Methods:

• An observational study included 97 patients undergoing total arch replacement and frozen elephant trunk technique from January 2018 to June 2021.
• Patients were divided into two groups: 35 undergoing the branch-priority technique and 62 undergoing the classic technique.
• Perioperative outcomes were analyzed to compare the two surgical approaches.

Main Results:

• The branch-priority group demonstrated significantly shorter cardiopulmonary bypass times, ventilator durations, and earlier postoperative wake-up times compared to the classic group.
• Patients in the branch-priority group experienced shorter ICU stays, with a significant reduction in neurological complications and 24-hour drainage.
• The branch-priority technique showed superior outcomes in terms of brain protection and reduced postoperative recovery metrics.

Conclusions:

• The branch-priority technique offers enhanced brain protection during STAAD surgery.
• This approach leads to earlier patient awakening, fewer neurological complications, reduced ventilation time, and shorter ICU hospitalization.
• The branch-priority technique is recommended for its effectiveness in improving outcomes for aortic dissection surgeries.