Comparison Of The Near-medium Term Results Of Aortic Arch Reconstruction With Integrated Triple-branched Stent Graft And Modified Triple-branched Stent Graft In Acute Standford A Aortic Dissection

Objective:Comparison of the near-medium term results of aortic arch reconstruction with integrated triple-branched stent graft and modified triple-branched stent graft in acute Standford A aortic dissection.Methods:From Jan.2012 to Dec.2014,75 patients with acute Stanford A aortic dissection who used integrated triple-branched stent graft for arch reconstruction(Group A).Concurrently,107 cases of acute Stanford A aortic dissection used modified triple-branched stent graft(Group B).Collected all of the clinical features before operation,the condition of operation and the postoperation curative effect of the patients in the groups.The statistical analysis was carried out by using SPSS 19.0 statistical software package.The difference was set as P < 0.05,and there was statistical significance.The survival curve was determined by Kaplan-Meier curve and Log-Rankassess group difference.Results:Patient chararteristics and in-hospital mortality of two groups were similar.there was no difference in the processing method of the aortic root,operation time,cardiopulmonary bypass time,and the time of aortic crossclamp.But there was significant difference in cerebral perfusion time and circulatory arrest between the two groups.Postoperative data were no different between the groups.During the three years after surgery,there were 3 deaths in the group A,and 4 deaths in the group B.On postoperative computed tomography,in group A,8 patients' false lumen were not closed with thrombus at the stent location,however in group B,there was only 1 case,the difference between the two groups were statistically significant.There was no difference in the diameter of the largest thoracic aorta between 1 month and 3 years in both groups.And the false lumen thrombosis rate were no significance difference between the two groups.In group A,6 cases of stenting vascular stenosis occurred,and 1 case in the group B,the difference was statistically significant.There was no significant difference in the 3-year survival rate between the two groups.Conclusion:1.Both the results of aortic arch reconstruction with integrated triple-branched stent graft and modified triple-branched stent graft in acute Standford A aortic dissection can abtain good near-medium result.2.The modified triple-branched stent graft was better than the integrated triple-branched stent graft on endoleaks and stent narrow incidence rate.