Clinical Research About The Outcome Of Using Triple-Branched Stent Graft To Repair Acute Stanford Type A Aortic Dissection

Objective:To compare and analyze the short-term and long-term outcomes of using triple-branched stent graft with using Sun’s Procedure in repairing acute Stanford type A aortic dissection.Besides the best surgical procedure and treatment for acute Stanford type A aortic dissection will be discussed.Methods:From March 2010 to February 2015,86 patients in Nanjing Drumtower Hospital with acute Stanford type A aortic dissection were divided into two groups according to their surgical procedure.The triple-branched stent graft group(Group Triple-Branched)included 39 patients while the Sun’s procedure group(Group Sun’s)included 47.The medical records of patients were consulted and statistics of their preoperative information,indexes in the operation,postoperative mortality,complications occurred and other data were gathered.Then the survival conditions,aorta diameters,outcomes of false lumens were assessed by clinical and telephone follow-up.Moreover,the life quality of patients were assessed by the SF-36 health survey.Results:Group Triple-Branched had no significant differences compared to Group Sun’s in terms of operation time and blood transfusion.Group Triple-Branched had 6 deaths while Group Sun’s had 7.They had no significant differences in terms of mortality,rate of complications,duration of ventilation,ICU duration,re-operation,re-intubation and the usage rate of mechanical equipment(ECMO,CRRT).In the follow-up,Group Sun’s was better than Group Triple-Branched in terms of false lumen outcomes within 1 year.Except for these,the 2 groups had no significant differences in terms of survival conditions,aorta diameter and health condition in the different dimensions assessed by SF-36 health survey.Conclusion:The implantation of triple-branched stent graft has a similar short-term clinical effect compared with Sun’s procedure.It simplifies the operating procedure and reduces the operation difficulty.But its use is limited,and its results on the stent-covering false lumen outcome is worse than Sun’s procedure.So the implantation of triple-branched stent graft is feasible but a general preoperative assessment and choosing the proper patients are important.