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| Comparison of the Effects of Total Arch Replacement and Right Hemiarch Replacement on the Prognosis of Patients With Acute Stanford Type A Aortic Dissection |
| Pan Junhui1, Zhang Xiangli2, Mei Yongcheng1, Yu Sen1 |
1. Department of Cardio-Vascular Surgery,Zhumadian Central Hospital,Zhumadian 463000,China;
2. The Seventh People's Medical Center of Zhengzhou,Zhengzhou 450000,China |
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Abstract Objective To study the effect of total arch replacement and right hemiarch replacement on the prognosis of patients with acute Stanford A aortic dissection.Methods The clinical data of 66 patients with acute Stanford A aortic dissection were retrospectively analyzed.They were divided into total arch group（n=36 cases,total aortic arch replacement）and right half arch group（n=30 cases,Application of right aortic arch replacement）.Compare the perioperative indicators [cardiopulmonary bypass,aortic occlusion,selective cerebral perfusion time,ICU stay time],laboratory indicators [C- reactive protein（CRP）,D- dimer（D-D）] before and 48 hours after operation,and compare the prognosis of the two groups [perioperative death,second operation and complications within one year after operation].Results There was no significant difference in ICU stay time between the two groups（P>0.05）.Other perioperative indicators in the right half arch group were significantly lower than those in the total arch group（P<0.05）.The CRP and D-D levels in the two groups increased 48 hours after operation compared with those before operation,while those in the right half arch group were lower than those in the full arch group at the same time,and the differences were statistically significant（P<0.05）.However,there was no significant difference in prognosis between the two groups（P>0.05）.Conclusion Right hemi-arch replacement can reduce the waiting time of cardiopulmonary bypass,reduce the hypothermia injury,relieve the stress and inflammatory reaction of the body,and be beneficial to the postoperative recovery of patients.
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Received: 01 December 2021
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2023, Vol. 43 
