The Clinical Application Of Modified Distal Aortic Arch Occlusion In Acute Stanford Type A Aortic Dissection

Objective:By comparing the intraoperative and prognostic results of two different circulatory arrest techniques in acute Stanford type A aortic dissection,we aim to investigate clinical application of modified distal aortic arch occlusion in the protection of important organs.Methods:A retrospective study included 96 patients with acute Stanford type A aortic dissection who received surgical treatment in the department of cardic surgery of Second Affiliated Hospital of Nanchang University between June 2016 and June 2019.There were 49 males and 47 females with mean age of 50.24�8.79 years.These patients were retrospectively divided into two groups according to the different methods and temperatures of circulatory arrest during operation: the modified group(n=58)and the conventional group(n=38).Perioperative clinical indicators,including the general situation,operative data,and postoperative course,were analyzed and compared between these two groups.And clinical follow-up for all the patients were routinely conducted after the end of treatment.Afterwards,the clinical efficacy of the modified distal aortic arch occlusion was evaluated based on the above data.Results:3 cases died(they all suffered from postoperative multiple organ failure)after conventional operation,1 case died(1 case of Intraoperative stent was placed in the pseudocavity)after modified operation,while the remaining patients had been almost discharged successfully.It had no significant differences in gender,age,weight,history of hypertension,aortic-cross duration,postoperative waking time and postoperative mechanical ventilation duration.The operation time,cardiopulmonary bypass time,circulatory arrest time of the modified group were significantly shorter than that of the conventional group(P<0.05).Moreover,the modified group was obviously surperior to the conventional group in drainage of the first 24 hours,blood transfusion,ICU stay,postoperative complications and postoperative hospital stay(P < 0.05).Conclusion:The present results adequately demonstrated that the modified distal aortic arch occlusion can considerably shorten the duration of circulatory arrest.Also,the clinical efficacy was satisfactory for protecting vital organ function effectively and reducing the rate of postoperative complications.Thus,it was safe and reliable in the application of acute Standford Type A aortic dissection and deserved further study.