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Comparison of two techniques in proximal anastomosis in acute type A aortic dissection
BACKGROUND: The proximal anastomosis is an important procedure during the acute type A aortic dissection (AAAD) surgery. The conventional method is a double patch sandwich technique with Teflon felt. Adventitial eversion and prosthesis eversion technique as a novel approach has been applied to many...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643206/ https://www.ncbi.nlm.nih.gov/pubmed/36386353 http://dx.doi.org/10.3389/fcvm.2022.1047939 |
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author | Fang, Changcun Gao, Shan Ren, Xiao Pang, Xinyan Zhao, Xin Ma, Zengshan Wang, Chen Liu, Kai |
author_facet | Fang, Changcun Gao, Shan Ren, Xiao Pang, Xinyan Zhao, Xin Ma, Zengshan Wang, Chen Liu, Kai |
author_sort | Fang, Changcun |
collection | PubMed |
description | BACKGROUND: The proximal anastomosis is an important procedure during the acute type A aortic dissection (AAAD) surgery. The conventional method is a double patch sandwich technique with Teflon felt. Adventitial eversion and prosthesis eversion technique as a novel approach has been applied to many patients in our center. Herein, This technique would be introduced, and the perioperative and 1-year follow-up results of the two different anastomosis methods were also evaluated. METHODS: Between December 2017 and May 2021, 143 AAAD patients who underwent total arch replacement (TAR) and frozen elephant trunk (FET) implantation were included in this retrospective study. Patients were divided into the eversion technique group (adventitial eversion and prosthesis eversion technique for proximal anastomosis, n = 64) and the sandwich technique group (n = 79). RESULTS: The medical records were analyzed and compared between the groups. The mean operation time was 466 ± 73 min in the eversion technique group and 513 ± 81 min in the sandwich technique group (P < 0.001). Compared with the sandwich technique group, the eversion technique group also showed a shorter time on proximal anastomosis (38 ± 12 min vs. 58 ± 20 min, P < 0.001), cardiopulmonary bypass (195 ± 26 vs. 211 ± 40 min, P = 0.003), and aortic cross-clamp (120 ± 23 min vs. 134 ± 27 min, P = 0.002). Furthermore, a decreased proportion of >600 ml fresh frozen plasmas transfusion was observed in eversion technique group (10.9% vs. 34.2%, P = 0.002). No statistical differences were found in the postoperative morbidities and 1-year follow-up outcomes. CONCLUSION: Proximal anastomosis with adventitial eversion and prosthesis eversion technique is a promising surgical option for AAAD patients, with favorable perioperative and 1-year follow-up results. |
format | Online Article Text |
id | pubmed-9643206 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96432062022-11-15 Comparison of two techniques in proximal anastomosis in acute type A aortic dissection Fang, Changcun Gao, Shan Ren, Xiao Pang, Xinyan Zhao, Xin Ma, Zengshan Wang, Chen Liu, Kai Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: The proximal anastomosis is an important procedure during the acute type A aortic dissection (AAAD) surgery. The conventional method is a double patch sandwich technique with Teflon felt. Adventitial eversion and prosthesis eversion technique as a novel approach has been applied to many patients in our center. Herein, This technique would be introduced, and the perioperative and 1-year follow-up results of the two different anastomosis methods were also evaluated. METHODS: Between December 2017 and May 2021, 143 AAAD patients who underwent total arch replacement (TAR) and frozen elephant trunk (FET) implantation were included in this retrospective study. Patients were divided into the eversion technique group (adventitial eversion and prosthesis eversion technique for proximal anastomosis, n = 64) and the sandwich technique group (n = 79). RESULTS: The medical records were analyzed and compared between the groups. The mean operation time was 466 ± 73 min in the eversion technique group and 513 ± 81 min in the sandwich technique group (P < 0.001). Compared with the sandwich technique group, the eversion technique group also showed a shorter time on proximal anastomosis (38 ± 12 min vs. 58 ± 20 min, P < 0.001), cardiopulmonary bypass (195 ± 26 vs. 211 ± 40 min, P = 0.003), and aortic cross-clamp (120 ± 23 min vs. 134 ± 27 min, P = 0.002). Furthermore, a decreased proportion of >600 ml fresh frozen plasmas transfusion was observed in eversion technique group (10.9% vs. 34.2%, P = 0.002). No statistical differences were found in the postoperative morbidities and 1-year follow-up outcomes. CONCLUSION: Proximal anastomosis with adventitial eversion and prosthesis eversion technique is a promising surgical option for AAAD patients, with favorable perioperative and 1-year follow-up results. Frontiers Media S.A. 2022-10-26 /pmc/articles/PMC9643206/ /pubmed/36386353 http://dx.doi.org/10.3389/fcvm.2022.1047939 Text en Copyright © 2022 Fang, Gao, Ren, Pang, Zhao, Ma, Wang and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Fang, Changcun Gao, Shan Ren, Xiao Pang, Xinyan Zhao, Xin Ma, Zengshan Wang, Chen Liu, Kai Comparison of two techniques in proximal anastomosis in acute type A aortic dissection |
title | Comparison of two techniques in proximal anastomosis in acute type A aortic dissection |
title_full | Comparison of two techniques in proximal anastomosis in acute type A aortic dissection |
title_fullStr | Comparison of two techniques in proximal anastomosis in acute type A aortic dissection |
title_full_unstemmed | Comparison of two techniques in proximal anastomosis in acute type A aortic dissection |
title_short | Comparison of two techniques in proximal anastomosis in acute type A aortic dissection |
title_sort | comparison of two techniques in proximal anastomosis in acute type a aortic dissection |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643206/ https://www.ncbi.nlm.nih.gov/pubmed/36386353 http://dx.doi.org/10.3389/fcvm.2022.1047939 |
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