ẢNH HƯỞNG CỦA HÌNH THÁI GIẢI PHẪU QUAI ĐỘNG MẠCH CHỦ TRONG PHẪU THUẬT LÓC ĐỘNG MẠCH CHỦ LOẠI A CẤP TÍNH

Abstract

Objectives: The relationship between anatomical characteristics of the aortic arch and the risk of type A aortic dissection and surgery for this disease remained unclear. This study evaluated the effects of the types of normal aortic arch on acute type A aortic dissection surgery. Methods and results: We retrospectively reviewed all patients with acute type A aortic dissection who underwent surgery at Viet Duc University Hospital from January 2021 to December 2022. Of total 89 patients, 5 patients had abnormal aortic arch anatomy. Among the group with normal aortic arch, type I group had the highest rate (57.1%), 3 times higher than type II (19.0%) and over 2 times higher than type III (23.8%). Type II arch group had a significantly higher history of hypertension, while patients with type III arch were more likely to have visceral vessel injuries than the other two groups. Postoperatively, the early mortality rate and early reoperation rate were 11.2% and 5.6%, respectively. The most common cause of postoperative early death was multiorgan failure and this of reoperation was bleeding. The types of the normal aortic arch showed no significant influence on surgical characteristics and early outcomes after surgery for acute type A aortic dissection. Conclusions: The anatomical morphology of the normal aortic arch may be a risk factor for acute type A aortic dissection and the predictor in surgery for this disease, especially type III arch configuration, however, more systematic and in-depth studies are required to clarify this issue.