Analysis of the effect of Preset Cabrol in total arch replacement for type A aortic dissection.

BACKGROUND

Hemostasis can be challenging after ascending aorta replacement and Sun's procedure. This study aims to assess the impact of employing the Preset Cabrol technique during these procedures.

METHODS

A retrospective analysis was conducted on 258 consecutive patients diagnosed with type A aortic dissection (TAAD) who underwent ascending aortic replacement and Sun's procedure between January 2021 and January 2024. The patients were divided into two groups: the preset group (n=203) and the control group (n=55).

RESULTS

There were no significant differences between the groups in terms of 30-day mortality (preset: 6.9% control: 7.3%, P=0.92) and aortic cross-clamp time [preset: 64.9±12.3 minutes (range, 51-106 minutes) control: 63.5±13.1 minutes (range, 45-138 minutes), P=0.48]. However, the preset group demonstrated significantly shorter operation time [298.6±48.4 minutes (range, 251-410 minutes) control: 365.6±75.3 minutes (range, 248-605 minutes)] and cardiopulmonary bypass (CPB) time [119.8±15.3 minutes (range, 88-148 minutes) control: 148.5±41.8 minutes (range, 86-225 minutes)] (P<0.001). Additionally, the preset group required fewer blood product transfusions, had shorter mechanical ventilation durations (P=0.049), and incurred lower total hospitalization costs (P=0.02). No persistent shunts or complications related to thrombus accumulation were observed during postoperative follow-up.

CONCLUSIONS

The Preset Cabrol technique is proven to be a valuable tool during ascending aortic replacement and Sun's procedure. It effectively controls bleeding, leading to reduced CPB and operation times, decreased blood product transfusion, and lower hospitalization costs.