Diagnosis and surgical treatment of stanford type A aortic dissection

LI Ling-ke; ZHU Jun-ming; ZHANG Hong-chao; HOU Mai; XU Jin-xing; CHEN Yuan-heng

Abstract：ObjectiveWe attempted to study the diagnosis and surgical treatment of Stanford type A aortic dissection, a serious and complicated disease.Methods15 cases of Stanford type A aortic dissection received surgical treatment from January 1994 to December 2013, and their diagnosis was made by CTA, MRI and UCG. Right subclavian arterial cannulation and cavoatrial cannulation were used to set up cardiopulmonary bypass, and deep hypothermic circulation arrest with selective cerebral perfusion was employed in 3 cases of aortic arch replacement and endovascular stent repair. Different operations were adapted according to the rupture site, dissecting extent and aortic valve regurgitation: including Bentall(8 cases), Bentall with partial arch replacement (4 cases), Bentall with arch replacement and stented elephant truck (SUN’s procedure,3 cases).ResultsThe average CPB time was (142.6±16.3) min, clamp time was (80.2±9.5) min, and circulation arrest time was (20.1±6.7) min. There was one death.ConclusionSurgical treatment of Stanford type A aortic dissection significantly reduced the mortality. The basic surgical principle is to eliminate false lumen, then to replace dissecting aorta and to reestablish blood supply of aortic branches.