Outcome Of Comparison Between Sun’s Procedure And Hybrid Aortic Arch Debranching Procedure In Acute Type Ⅰ Aortic

Objective Our goal was to compare the Sun’s procedure and the hybrid aortic arch debranching procedure for acute Type Ⅰ aortic dissection.Methods From March 2015 to May 2017,85 patients with Type Ⅰ aortic dissection were analysed retrospectively who underwent extensive procedures by department of cardiovascular surgery in the first hospital of Lanzhou university,.There were 64 patients underwent Sun’s procedure(Sun’s group)and 21 underwent hybrid aortic arch debranching procedure(hybrid aortic arch debranching group).Perioperative data and mid-term follow-up results were assessed.Results In comparison with the Sun’s group,the patients in the branching group were older(48.5±8.6vs53.8±8.2,p = 0.016);obesity rate was higher(4.7%vs23.8%,p = 0.030);The hepatic dysfunction rate before operation was higher(0vs14.3%,p = 0.003);aortic clamp time was shorter(151.8±33.5min vs 127.6±47.9,p = 0.041);the CBP time was shorter(259.7±53.8min,vs216.0±48.2min,p = 0.001);postoperative ventilation time was shorter(89.3±92.1h vs 38.2±42.0h,p=0.023);postoperative in-hospital time was shorter(31.0±10.1d,vs25.3±6.5d,p=0.028);the volume of perioperative red blood infusion was less(6.6± 5.2u vs3,6± 2.2u,p < 0.001);the amount of plasma used was less(1407.3±597.2ml vs1026.2±579.8ml,p=0.012);the amount of cryoprecipitate used was less(10.7±8.1U vs3.4±5.6U,p < 0.001;the rate of pulmonary infection was lower(70%vs42.1%,p=0.028),the difference was statistically significant(p < 0.05).There were no significant differences in the 30-day mortality rate and annual survival rate between the two groups.Conclusions The hybrid aortic arch procedure was a novel operation method,can be safely performed on patients with acute Type Ⅰ aortic dissection;espically on high risk patients.