Clinical Outcomes of VasoRing Connector in Patients With Acute Type A Aortic Dissection

Autor: Shih-Hsien Weng, Hsiao-Huang Chang, Chiao-Po Hsu, I-Ming Chen, Chun-Che Shih, Po-Lin Chen, Jeng Wei
Rok vydání: 2018
Předmět:
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Elephant trunks
Operative Time
Taiwan
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Anastomosis
Prosthesis Design
Risk Assessment
Statistics
Nonparametric
Cohort Studies
Blood Vessel Prosthesis Implantation
03 medical and health sciences
Aortic aneurysm
0302 clinical medicine
Aneurysm
Blood vessel prosthesis
medicine.artery
medicine
Humans
Aged
Retrospective Studies
Aortic dissection
Aorta
Aortic Aneurysm
Thoracic
business.industry
Anastomosis
Surgical
Suture Techniques
Length of Stay
Middle Aged
medicine.disease
Sternotomy
Blood Vessel Prosthesis
Surgery
Survival Rate
Aortic Dissection
Treatment Outcome
030228 respiratory system
Cardiothoracic surgery
Acute Disease
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: The Annals of Thoracic Surgery. 106:764-770
ISSN: 0003-4975
DOI: 10.1016/j.athoracsur.2018.03.056
Popis: Outcomes of acute type A aortic dissection repair may be improved when VasoRing connectors (VRC [Sunwei Technology, Taipei, Taiwan]) are used to facilitate aortic anastomosis. In the present study, we compared the results of acute type A aortic dissection repair using VRC and conventional suture technique.A total of 68 patients who underwent acute type A aortic dissection repair by total arch replacement and antegrade frozen elephant trunk procedure at our institution were enrolled. Records of patients receiving aorta anastomosis with VRC (n = 33) and conventional suture (n = 35) were retrospectively compared. All the surgical results were collected and analyzed.The results showed that the VRC group exhibited significance in total operative time (326 ± 80 minutes versus 362 ± 34 minutes, p = 0.023), cardiopulmonary bypass time (97 ± 10 minutes versus 134 ± 15 minutes, p0.001), aortic cross-clamp time (97 ± 10 minutes versus 134 ± 15 minutes, p0.001), and circulatory arrest time (15 ± 4 minutes versus 50 ± 8 minutes, p 0.001) compared with the suture group. Use of VRC for aortic anastomosis led to significantly less perioperative blood loss (442 ± 75 mL versus 849 ± 419 mL, p 0.001) compared with conventional suture for aortic anastomosis There was no reoperation for postoperative bleeding in the VRC group whereas reoperation for postoperative bleeding occurred in 20% of the suture group (0% versus 20%, p = 0.011). Postoperative blood loss, amount of blood transfusion, and acute kidney injury requiring hemodialysis were also significantly less in the VRC group than the suture group.Use of VRC shortened operative time and improved bleeding control incorporating standard methods for aortic anastomoses during acute type A aortic dissection repair by total arch replacement and antegrade frozen elephant trunk procedure. Long-term follow-up and randomized comparison are needed to confirm VRC efficacy.
Databáze: OpenAIRE
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