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One-stop hybrid versus conventional surgery for acute type A aortic dissection: a randomized controlled trial
Weichao Zhao1, Mian Li2, Wuhui Hou1
1Department of Cardiovascular Surgery, The Fourth Hospital of Hebei Medical University, No.12 Jiankang Road, Changan District, Shijiazhuang, Hebei, 050011, China.
Journal of Cardiothoracic Surgery
|December 6, 2025
Summary
One-stop hybrid surgery offers better outcomes for Stanford type A aortic dissection patients than conventional methods. This approach improves survival rates and reduces complications, enhancing patient recovery and quality of life.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Stanford type A aortic dissection (TAAD) is a life-threatening condition requiring urgent surgical intervention.
- Conventional surgical approaches, such as aortic arch replacement plus stented elephant trunk (Sun's procedure), have established efficacy but can involve prolonged procedures and significant morbidity.
Purpose of the Study:
- To compare the clinical efficacy and prognostic impact of one-stop hybrid surgery versus conventional Sun's procedure for TAAD.
- To evaluate perioperative outcomes, postoperative complications, aortic remodeling, and short-term survival rates between the two surgical techniques.
Main Methods:
- A prospective randomized controlled trial involving 140 patients with acute TAAD.
- Patients were randomized into two groups: Conventional Group (Sun's procedure, n=70) and Hybrid Group (one-stop hybrid surgery, n=70).
- Key outcome measures included operative time, cardiopulmonary bypass duration, cross-clamp time, postoperative complications, length of stay, aortic remodeling via CTA, and 30-day survival.
Main Results:
- The Hybrid Group demonstrated significantly shorter operative times, cardiopulmonary bypass durations, and aortic cross-clamp times compared to the Conventional Group.
- Patients undergoing hybrid surgery experienced significantly lower rates of pulmonary infections, hypoxemia, stroke, and reoperation for bleeding.
- Hybrid surgery resulted in shorter ICU and hospital stays, superior aortic remodeling at 1 and 3 months post-surgery, and a higher 30-day survival rate (91.4% vs. 78.6%).
Conclusions:
- One-stop hybrid surgery is a safe and effective therapeutic option for selected TAAD patients.
- This approach offers superior perioperative outcomes, reduced morbidity, and enhanced short-term survival compared to the conventional Sun's procedure.
- Hybrid surgery may lead to an improved quality of life for patients with Stanford type A aortic dissection.
