Gao Jianfeng, Yan Jie, Duan Yanyu, Yu Junjian, Li Wentong, Luo Zhifang, Yu Wenbo, Xie Dilin, Liu Ziyou, Xiong Jianxian
The First Clinical Medical College, Gannan Medical University, Ganzhou, China.
Department of Thoracic Surgery, The First People's Hospital of Nankang District, Ganzhou, China.
Front Cardiovasc Med. 2024 Jan 23;10:1321700. doi: 10.3389/fcvm.2023.1321700. eCollection 2023.
Acute Stanford type A aortic dissection (STAAD) is a fatal condition requiring urgent surgical intervention. Owing to the complexity of the surgical process, various complications, such as neurological disorders, are common. In this study, we prioritized the reconstruction of aortic arch branches during surgery and investigated the association between prioritizing the branches and the postoperative outcomes of patients with STAAD.
Ninety-seven patients were included in the observational study and underwent total arch replacement and frozen elephant trunk technique between January 2018 and June 2021. Of these, 35 patients underwent the branch-priority technique, and 62 patients underwent the classic technique. By analyzing the perioperative outcomes, we compared the differences between the two techniques.
The branch priority group had significantly shorter cardiopulmonary bypass and ventilator times and earlier postoperative wake-up times than the classic group. Additionally, the ICU stay time was shorter, with a significant decrease in neurological complications and 24 h drainage in the branch priority group compared to the classic group.
The branch priority technique can effectively provide better brain protection, resulting in earlier awakening of patients after surgery, reduced neurological complications, shorter ventilation time and decreased ICU hospitalization time. Therefore, it is recommended for use in aortic dissection surgeries.
急性斯坦福A型主动脉夹层（STAAD）是一种需要紧急手术干预的致命疾病。由于手术过程复杂，各种并发症，如神经功能障碍很常见。在本研究中，我们在手术过程中优先进行主动脉弓分支重建，并研究了分支优先处理与STAAD患者术后结局之间的关联。
97例患者纳入观察性研究，于2018年1月至2021年6月接受全弓置换和冰冻象鼻技术。其中，35例患者采用分支优先技术，62例患者采用经典技术。通过分析围手术期结局，我们比较了两种技术之间的差异。
与经典组相比，分支优先组的体外循环和呼吸机使用时间显著缩短，术后苏醒时间更早。此外，分支优先组的重症监护病房停留时间更短，神经并发症和24小时引流量与经典组相比显著减少。
分支优先技术能有效提供更好的脑保护，使患者术后更早苏醒，减少神经并发症，缩短通气时间，降低重症监护病房住院时间。因此，推荐用于主动脉夹层手术。
