[Proximal Stepwise Anastomosis in Stanford Type A Acute Aortic Dissection Surgery]

Bleeding from the proximal anastomosis site during Stanford type A acute aortic dissection(AAAD)surgery can be a fatal problem, to avoid this, we use the proximal stepwise(PS)method for proximal anastomosis at our institution, and we examined its usefulness and results, we retrospectively analyzed 53 emergency surgeries(22 males, mean age 72.4±9.3 years)performed between October 2016 and December 2024, there were 39 ascending replacements and 12 total ascending replacements, there were no cases of difficult hemostasis during proximal anastomosis, the in-hospital mortality rate was 3.7%(2 cases), during the observation period of 1,245.7±924.6 days, there were no aortic events or aortic-related deaths related to the proximal anastomosis, and the 3-year survival rate was 93.4%, the PS method is useful as a proximal anastomosis technique in AAAD surgery and may contribute to a favorable long-term prognosis by avoiding late complications.