EARLY RESULTS OF SURGERY FOR ACUTE TYPE A AORTIC DISSECTION AT VIET DUC UNIVERSITY HOSPITAL IN PERIOD 2018 - 2021

Phùng Duy Hồng Sơn1,2, Nguyễn Hữu Phong1,2, Nguyễn Hữu Ước1,2,
1 Vietnam-Germany Friendship Hospital
2 Hanoi Medical University

Main Article Content

Abstract

Introdution: Emergency open-heart surgery for acute type A aortic dissection - a life threatening cardiovascular disease, has become routine at Viet Duc university hospital. There were some reports in previous years to 2016. This study aims to evaluate the early results of surgery for the period 2018-2021, with many advances in technique and equipment - materials. Patients and methods: This is retrospective descriptive study with convenience sample size. All patients, who underwent operation with acute type A aortic dissection during period from January 2018 to December 2021 were included in the analysis. Results: There were 201 patients with mean age 57 ± 12 years and 76.7% patients were male. The most common preoperative complication was acute cardiac tamponade (7,5%). 4% patients had Marfan phenotype. The ascending aorta replacement was in 51,2% cases, the hemiarch and total arch replacements ware 16.9% and 22.9% respectively, from this the frozen elephant trunk procedure was in 10.9%. The average length of ICU stay was 12.1 ± 18.8 days, the rate of tracheostomy was 15.8%. In hospital mortality was 10.9%. Conclusion: In recent years, we have applied many diverse and up-to-date surgical techniques to treat acute type A aortic dissection with early positive results.

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References

1. Gudbjartsson T, Ahlsson A, Geirsson A, et al. Acute type A aortic dissection – a review. Scand Cardiovasc J. 2020;54(1):1-13. doi:10.1080/ 14017431.2019.1660401
2. Malaisrie SC, Szeto WY, Halas M, et al. 2021 The American Association for Thoracic Surgery expert consensus document: Surgical treatment of acute type A aortic dissection. J Thorac Cardiovasc Surg. 2021;162 (3):735-758.e2. doi:10.1016/ j.jtcvs.2021.04.053
3. Kazui T, Washiyama N, Bashar AHM, et al. Surgical outcome of acute type A aortic dissection: analysis of risk factors. Ann Thorac Surg. 2002; 74(1):75-81. doi:10.1016/S0003-4975(02)03603-2
4. Girdauskas E, Kuntze T, Borger MA, Falk V, Mohr FW. Surgical risk of preoperative malperfusion in acute type A aortic dissection. J Thorac Cardiovasc Surg. 2009;138(6):1363-1369. doi:10.1016/j.jtcvs.2009.04.059
5. Nguyễn Hữu Ước, Vũ Ngọc Tú. Đánh giá kết quả phẫu thuật lóc động mạch chủ Type A tại Bệnh viện Việt Đức. Tạp Chí Phẫu Thuật Tim Mạch Và Lồng Ngực Việt Nam. 2013; 4:59-65. doi:10.47972/vjcts.v4i.326
6. Lenos A, Bougioukakis P, Irimie V, Zacher M, Diegeler A, Urbanski PP. Impact of surgical experience on outcome in surgery of acute type A aortic dissection†. Eur J Cardiothorac Surg. 2015;48(3):491-496. doi:10.1093/ejcts/ezu454
7. Pape LA, Awais M, Woznicki EM, et al. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015;66(4):350-358. doi:10.1016/ j.jacc.2015.05.029
8. Zindovic I, Gudbjartsson T, Ahlsson A, et al. Malperfusion in acute type A aortic dissection: An update from the Nordic Consortium for Acute Type A Aortic Dissection. J Thorac Cardiovasc Surg. 2019;157(4):1324-1333.e6. doi:10.1016/j.jtcvs.2018.10.134
9. Phung DHS, Nguyen TS, Pham VL, Doan QH, Nguyen HU. A novel modification of frozen elephant trunk technique: unique protocol from one institution. Eur Rev Med Pharmacol Sci 2021 25 14 4738-4745 DOI 1026355eurrev20210726384.