Application Of Autologous Pericardium In Aortic Sinus Plasty Of Stanford Type A Aortic Dissection

Objective To investigate the effect of aortic sinus plasty with autologous pericardium in Stanford type A aortic dissectionMethods 87 Stanford A aortic dissection patients diagnosed and surgery treated in Henan provincial People’s Hospital from September 2017 to December 2019 were selected and according to the aortic root whether to perform aortic sinus plasty is divided into group Bentall(Bentall surgery group,45 cases)and group autologous pericardium plasty(Aortic sinus plasty with autologous pericardium group,42 cases).Observe and compare cardio pulmonary bypass time(CPBT),aortic occlusion time(ACCT),stop circulation time(SCT),intensive care unit(ICU)stay time,postoperative thoracic drainage,and total blood transfusion volume of the two groups of patients,Analysis of the follow-up data include the aortic sinus diameter,left ventricular ejection fraction(LVEF),aortic regurgitation,survival rate,mortality,and complications occurred at 1week and 3 months after surgery.Results(1)There was no significant difference in CPBT,ACCT,and SCT between patients in group Bentall and group autologous pericardium plasty(P> 0.05).(2)There was no significant difference in the ICU stay time and the thoracic drainage between the patients in group Bentall and group autologous pericardium plasty(P> 0.05);the total blood transfusion volume in group autologous pericardium plasty was significantly less than that in group Bentall(P < 0.05).(3)The aortic sinus diameter,LVEF,and the degree of aortic regurgitation in the two groups were significantly improved at 1 week and 3 months after operation,and there was no statistically significant difference between the groups(P> 0.05).(4)There was no significant difference in survival rate and mortality(91.11% VS90.48%,8.89% VS9.52%)between group Bentall and group autologous pericardium plasty patients(P > 0.05).(5)The incidence of bleeding and thrombotic complications(0.00%,0.00%)in group autologous pericardium plasty was significantly lower than that in group Bentall(11.11%,8.89%)(P <0.05).Conclusion Aortic sinus plasty with autologous pericardium can be used to treat Stanford type A aortic dissection,which can achieve similar effects to Bentall surgery,and can reduce the amount of blood transfusion and the complications associated with anticoagulant therapy,accord with physiology hemodynamics,be worth to popularize in the clinic.