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Updated: Jun 14, 2026

A New Murine Model of Endovascular Aortic Aneurysm Repair
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Thromboelastography-Based Risk-Stratified Transfusion Strategy in Acute Stanford Type A Aortic Dissection: A

Jiawei Zhu1,2, Qiuyong Guo2,3, Yi Jiang2,3

  • 1Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China.

Journal of Clinical Medicine
|May 13, 2026
PubMed
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This summary is machine-generated.

A new thromboelastography (TEG)-based transfusion protocol for acute type A aortic dissection (ATAAD) surgery effectively predicts bleeding. This risk-stratified approach reduces excessive bleeding and costs compared to conventional methods.

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Anesthesiology

Background:

  • Perioperative blood transfusion lacks guidelines for acute type A aortic dissection (ATAAD).
  • Excessive bleeding is a significant complication in ATAAD surgery.
  • Current transfusion practices are often empirical.

Purpose of the Study:

  • To investigate a thromboelastography (TEG)-based risk-stratified transfusion protocol for ATAAD patients.
  • To identify predictors of perioperative excessive bleeding in ATAAD.
  • To compare the efficacy of a TEG-based protocol versus conventional transfusion.

Main Methods:

  • Retrospective analysis of 57 ATAAD patients to identify bleeding predictors and develop a model.
  • Prospective validation of a TEG-based risk-stratified transfusion protocol in 47 ATAAD patients.
Keywords:
acute stanford type A aortic dissectionperioperative excessive bleedingpredictive modelrisk-stratified transfusion protocolthromboelastography

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  • Comparison of postoperative drainage, bleeding incidence, and costs between TEG-guided and conventional transfusion groups.

    • Main Results:

    • Preoperative activated clotting time (ACT) and TEG K-time independently predicted excessive bleeding (AUC 0.788).
    • The TEG risk-stratified group showed significantly lower postoperative drainage (p=0.046) and bleeding incidence (4.8% vs 34.6%, p=0.033).
    • Transfusion costs were reduced (p=0.029) in the TEG group without increased total transfusion volume.

    Conclusions:

    • Preoperative ACT and TEG parameters are effective predictors of perioperative bleeding in ATAAD.
    • A TEG-based risk-stratified transfusion protocol optimizes blood product use.
    • This evidence-based protocol improves outcomes and reduces costs in ATAAD perioperative management.