One minute of circulatory arrest for acute type A aortic dissection --------- a simple operation for acute type A aortic
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(2020) 15:328
RESEARCH ARTICLE
Open Access
One minute of circulatory arrest for acute type A aortic dissection --------- a simple operation for acute type A aortic dissection (AAAD) Detian Jiang1, Yufeng Huo1, Yimin Liu1, Yan Wang1, Jinfeng Zhou1, Xiangfei Sun2, Fen Zhao1, Yonghai Du1, Songxiong He1, Chao Liu1 and Wenyu Sun1*
Abstract Background: Sun’s procedure is currently recognized as the standard procedure for acute type A aortic dissection (AAAD). But the operation istoo difficult for beginners. We hope to reduce the difficulty and complications of this operation. Methods: The aortic arch was immediately cross-clamped after the stented graft was inserted into the distal aorta. Thereafter, the lower-body perfusion was restored. Then, anastomosis was performed between the proximal stent graft and the distal 4-branched Dacron graft. The other arteries were anastomosed to the arched branch of the 4branched graft. Results: The cardiopulmonary bypass (CPB) time was (207 ± 52) min, and the aortic cross-clamp time was (114 ± 39) min. The circulatory arrest time was (38 ± 16) sec. One patient (4%) died. The incidence of complications was stroke (4%), renal dysfunction requiring dialysis (4%), prolonged intubation(12%). Conclusions: The time of circulatory arrest in this operation is less than 1 min, which can avoid the complications caused by DHCA and decrease risk of bleeding and complexity by shifting anastomosis more proximally. The effect of our operation is similar to and even better than that of Sun’s procedure. It does not even require relatively advanced skill, much experience and excellent psychological quality, especially suitable for beginners. Keywords: Circulatory arrest , Acute type a aortic dissection, Operation, Sun’s procedure, One minute
Background Acute type A aortic dissection (AAAD) remains one of the most challenging diseases for cardiothoracic surgeons. In spite of technical improvements, the perioperative mortality rate is stillvery high. In the early stage of AAAD, the mortality rate increases by approximately 1% per hour [1–3]. Surgery is the most effective treatment. * Correspondence: [email protected] 1 Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Qingdao 266000, China Full list of author information is available at the end of the article
At present, the most common surgical methods for the treatment of AAAD are Sun’s procedure and hybrid operations [4]. Sun’s procedure is widely used because of its advanced techniques and good results,while it requires deep hypothermic circulatory arrest (DHCA). Hybrid surgeries can avoid DHCA, but they have more frequent long-term complications. We hope to reduce the difficulty of this operation on the basis of ensuringsurgical outcome. Our center tried a variety of surgical methods for the treatment of AAAD. At last,we coined one surgery which is based on Sun’s procedure and the
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use
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