Sutureless total arch replacement in patients with acute type A aortic dissection

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Disease

Background:

• Acute type A aortic dissection is a critical condition with high mortality.
• Current surgical interventions for aortic dissection have high in-hospital mortality rates.
• Novel surgical techniques are needed to improve outcomes in aortic dissection repair.

Purpose of the Study:

• To evaluate the safety and efficacy of sutureless total arch replacement.
• To compare sutureless total arch replacement with conventional total arch replacement in acute type A aortic dissection.
• To assess the impact of sutureless total arch replacement on operative efficiency and mortality.

Main Methods:

• Retrospective, single-center cohort study of 382 patients with acute type A aortic dissection.
• Comparison between 77 patients undergoing sutureless total arch replacement and 77 patients undergoing conventional total arch replacement after propensity score matching.
• Analysis of operative times, bleeding, in-hospital mortality, and postoperative complications.

Main Results:

• Sutureless total arch replacement demonstrated shorter operative time, cardiopulmonary bypass time, and circulatory arrest time.
• Reduced intraoperative bleeding was observed in the sutureless group (P < .01).
• Significantly lower in-hospital mortality rates were found in the sutureless total arch replacement group (P < .05).

Conclusions:

• Sutureless total arch replacement enhances operative efficiency and bleeding control in acute type A aortic dissection repair.
• This technique is associated with reduced in-hospital mortality.
• No significant differences in postoperative complications or long-term mortality were noted between the groups.