Surgical treatment of acute Stanford Type A aortic dissection
ZHANG Ke
TONG Jichun
ZHANG Ming
YIN Yajun
ZHONG Bin
WANG Yeming
MAO Yi
WU Qiyong
Abstract：Objective To investigate the emergency surgical treatment outcomes of acute Stanford A-type aortic dissection(TAAD)and the application value of Sun's procedure in municipal-level hospitals.Methods From February 2022 to October 2024,clinical data of 30 patients with acute TAAD undergoing emergency surgical treatment were collected in Department of Cardiothoracic Surgery of the Changzhou Second People's Hospital.All patients were confirmed by preoperative enhanced CTA of the aorta and underwent Sun's procedure(total aortic arch replacement with stented elephant trunk)combined with deep hypothermic circulatory arrest and selective cerebral perfusion.Postoperative outcomes,including ICU stay,hospitalization duration and perioperative complications,were observed.Regular follow-up was conducted to assess aortic and cardiac functions.Results Among the 30 patients,26 were discharged successfully,with a surgical success rate of 86.67%.The average cardiopulmonary bypass time was(245.50±55.88)minutes,and the average aortic cross-clamp time was(153.81±35.90)minutes.Of the 28 patients who safely returned to the ICU,the average duration of mechanical ventilation was(3.4±1.5)days,the average ICU stay was(6.5±2.1)days,and the average hospitalization duration was(22.9±6.5)days.The main postoperative complications included acute renal failure(17.8%)and cerebral infarction(10.7%),with a mortality rate of 7.1%(2 cases).During the 22-month follow-up,all 26 surviving patients had no new dissections,stent leakage,or displacement.Cardiac ultrasound at 1 year postoperatively showed a left ventricular end-diastolic dimension(LVED)of(51.5±4.3)mm,an ejection fraction(EF)of 59%±9%,and an average ascending aorta diameter of(28.1±2.5)mm.Conclusion Sun's procedure is effective in treating acute Stanford A-type aortic dissection,significantly reducing perioperative complications and mortality.Municipal-level hospitals can gradually establish a mature surgical treatment system for TAAD through team building and technical improvement,thereby enhancing the surgical success rate and long-term patient outcomes.
Keywords：acute Stanford A-type aortic dissectionSun's procedureemergency surgical treatmentperioperative management
Publication Date：2025-06-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 17-21 )