Outcomes of long versus short stent cronus hybrid prosthesis in type A aortic dissection: A single centre experience

Abstract Objective: To compare the outcome between trifurcated graft vs island technique for the treatment of type A aortic dissection in a single centre.Method: From september 2017 to september 2020, we studied 87 patients retrospectively, who underwent total arch replacement for type A aortic dissection. Out of which 51 patients, age(47.45 ± 10.47) years, 39(76.47%) males and 12(23.52%) females were surgically corrected by trifurcated branch graft technique and 36 patients age(52.75 ± 10.32) years, 27(75%) males and 9(25%) females with island technique. In both the groups, peri- operative outcomes were compared. Patients were followed up for 3 months and 6 months in both the groups.Result: Elective Surgery was done in 16(31.37%) and 6(16.66%) in trifurcated branch graft and island group respectively. Selective antegrade cerebral perfusion (SACP) was given by the Axillary artery in {48(94.11%) in trifurcated group and 3(8.33%) in island group, p=<.00001}.SACP was given by Innominate artery {5(9.83%) in trifurcated group and 33(91.66%) in island group, p=<.00001}. Trifurcated branch group and Island group had Cardiopulmonary Bypass time, cross clamp time, total circulatory arrest time of (245 ± 33.30),(117.62 ± 29.38),(54.33 ± 13.19) min and (195.88 ± 32.83),(70.11 ± 20.62),(33.52 ± 8.683)(p=<.00001); respectively. 30 day mortality was 5(9.83%) in trifurcated group and 3(8.33%) in island group (p=0.815).Conclusion: Trifurcated branched graft and island technique, have comparable results, only prerequisite being surgeons comfortability and experience. Trifurcated branch graft being associated with longer CPB, cross clamp and circulatory arrest time, but with no difference in overall adverse outcomes or mortality.

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Australian Single-Centre Outcome of Type-A Aortic Dissection Repairs Spanning 10 Years

Heart Lung and Circulation ◽

10.1016/j.hlc.2019.02.116 ◽

2019 ◽

Vol 28 ◽

pp. S105

Author(s):

J. Martinelli Nadal ◽

James Edwards ◽

Fabiano Viana ◽

Michael Worthington ◽

Robert Stuklis

Keyword(s):

Aortic Dissection ◽

Type A ◽

Single Centre ◽

Type A Aortic Dissection

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Unusual, Radical Treatment of Type A Aortic Dissection: A Case Report

Aorta ◽

10.1055/s-0040-1714090 ◽

2020 ◽

Vol 08 (04) ◽

pp. 111-115

Author(s):

Rossella M. Benvenga ◽

Michele Bellino ◽

Generoso Mastrogiovanni ◽

Donato Triggiani ◽

Rodolfo Citro ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Dissection ◽

Aortic Root ◽

False Lumen ◽

Type A ◽

Ascending Aorta ◽

High Morbidity ◽

Type A Aortic Dissection ◽

Native Aortic Valve ◽

Hybrid Prosthesis

AbstractType A aortic dissection, according to Stanford classification, is a surgical emergency with high morbidity and carries 56% of in-hospital mortality when surgical intervention is not performed. The surgical mortality at 30 days is 10 to 20%. The therapeutic goals are to replace the diseased ascending aorta and to treat or to monitor the distal aortic patent false lumen. When the dissection involves the aortic root and the architecture of aortic valve is normal, the surgical techniques used could be multiple: reinforce the aortic root and spare the native aortic valve or replace the aortic valve and the aortic root. The Florida sleeve technique has been developed to treat the aortic aneurysm, sparing the aortic valve in patients with connective tissue disease. Some case reports have described the use of this technique to treat an acute aortic dissection. In the following case, we present a single stage repair of the ascending aorta, aortic arch, and proximal intrathoracic aorta in a patient with Type A aortic dissection through the contemporaneous use of two techniques: Florida sleeve and Vascutek “Thoraflex” hybrid prosthesis. The use of these two techniques allows the repair/replacement of the proximal intrathoracic aorta, the sparing of the native aortic valve, the employment of a hybrid prosthesis to replace the supraortic vessels, and the creation of a descending aortic landing zone for later, distal intervention.

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