[Early outcomes of Sun's procedure in elderly patients with acute type A aortic dissection]

A total of 31 patients [17 males and 14 females, with a median (Q₁, Q₃) age of 73 (71, 75) years] over 70 years old with acute type A aortic dissection who underwent Sun's operation in Fuwai Central China Cardiovascular Hospital from October 2023 to June 2025 were included, and 11 patients [two males and nine females, with a median (Q₁, Q₃) age of 73 (71, 74) years] who underwent simplified ascending aorta replacement were included as the control group. In the Sun's procedure group, bilateral antegrade cerebral perfusion under mild hypothermia (28.1-32.0 ℃) was used for cerebral protection during circulatory arrest. The operation time was (6.6±1.5) h and (6.8±1.5) h, the tracheal intubation time was 39 (21, 132) h and 34 (16, 71) h, and the intensive care time was 113 (68, 179) h and 111 (43, 178) h in the Sun's procedure group and the control group, respectively, with no significant differences between the two groups (all P>0.05). In the Sun's procedure group, one patient died of intraoperative bleeding and another died of a new postoperative cerebral infarction. Therefore, the in-hospital mortality rate was 6.5% (2/31). There were no deaths in the control group. The results suggest that Sun's procedure under mild hypothermia combined with bilateral antegrade cerebral perfusion is an effective surgical treatment for patients over 70 years old with acute type A aortic dissection.