Short-term Outcomes of Modified Y-Graft Technique in Acute Type A Aortic Dissection Using the Femoral Artery Bypass and One Minute Systemic Circulatory Arrest Technique

Autor: Detian Jiang, Wenyu Sun, Fen Zhao, Liu Yimin, Qi Zhao, Yufeng Huo, Yonghai Du, Xiangfei Sun, Chao Liu, Songxiong He, Jinfeng Zhou
Rok vydání: 2020
Předmět:
Pulmonary and Respiratory Medicine
Adult
Male
medicine.medical_specialty
Time Factors
Femoral artery bypass
medicine.medical_treatment
lcsh:Surgery
Pulmonary infection
030204 cardiovascular system & hematology
One minute systemic circulatory arrest
lcsh:RD78.3-87.3
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
medicine
Humans
Survival rate
Aortic dissection
Aortic Aneurysm
Thoracic
business.industry
Ethics committee
General Medicine
lcsh:RD1-811
Middle Aged
medicine.disease
Cardiac surgery
Surgery
Acute type a aortic dissection
Femoral Artery
Survival Rate
Modified Y-graft technique
Aortic Dissection
Treatment Outcome
030228 respiratory system
Cardiothoracic surgery
Acute type
lcsh:Anesthesiology
Circulatory system
Heart Arrest
Induced
Female
Hemodialysis
Cardiology and Cardiovascular Medicine
business
Vascular Surgical Procedures
Research Article
Zdroj: Journal of Cardiothoracic Surgery, Vol 15, Iss 1, Pp 1-10 (2020)
Journal of Cardiothoracic Surgery
DOI: 10.21203/rs.2.24839/v2
Popis: Objective: Aortic arch replacement in acute type A aortic dissection patients remains a most challenging cardiovascular operation. This article aims to show our Modified Y-Graft Technique using the Femoral Artery Bypass (FAB) and the One Minute Systemic Circulatory Arrest (OSCA) Technique and assess the short-term outcomes of the patients. Methods: Between February 2015 and November 2017, 51 patients with acute type A aortic dissection underwent aortic arch replacement. Among them, 23 patients' procedure used FAB and 28 patients utilized both FAB and OSCA. The intraoperative data and postoperative follow-up data were recorded. The follow-up data of patients with traditional Y-graft technique were collected from previous reported studies. Results: In FAB group, two patients died for pulmonary infection (30-day survival rate 91.3%), and two patients paralyzed from the waist down. The hemodialysis was performed for five patients (21.7%) before hospital discharge. Fifteen patients (65.2%) received more than 2-day's respiratory support and 8 patients (34.8%) received more than 5-day's respiratory support. These follow-up data are basically flat or precede to the patients with traditional Y-graft technique. Furthermore, compared to the FAB Group, the morbidity of the neurologic dysfunction and the acute renal failure was significantly reduced in FAB+OSCA Group. Besides, the respiratory support, the length of the postoperative stay and the ICU stay were shortened. Conclusions: This study clarified the feasibility of FAB and OSCA technique in modifying Y-graft technique. The acute type A aortic dissection patients tend to have less surgical complications and favorable short-term outcomes by this surgery. Funding Statement: The study has no funding. Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: All procedures performed in studies involving human participants were approved by the Ethics Committee of Qilu Hospital of Shandong University.
Databáze: OpenAIRE
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