Work

Reduction of maximal false lumen area ratio by interactive cannulation perfusion in DeBakey type I acute aortic dissection repair

Year: 2025

Type: article

Abstract: Introduction: Acknowledging lacking of recognition on postoperative aortic remodeling by intraoperative transition of cannulation perfusion mode during the open repair surgery of DeBakey type I acute aortic dissection (AAD), this study aims to investigate the effect of interactive cannulation strategy on the maximum false lumen area (MFLA) ratio. Methods: A total of 321 AAD patients were retrospectively reviewed from March 2017 to March 2023, of which 166 patients receiving peripheral cannulation (PC, right axillary and femoral artery) and 155 patients receiving peripheral-to-centric cannulation (PCC, transition from right axillary and femoral artery to one branch of the tetrafurcated graft). The primary outcome was postoperative MFLA ratio in descending thoracic aorta. Secondary outcomes were postoperative inflammation response and anaerobic metabolism, hepatorenal dysfunction, and the ostium condition of branch artery of abdominal aorta involved by false lumen. Results: There was a lower postoperative MFLA ratio in PCC group than that in PC group, respectively (0.36±0.11 vs. 0.44±0.13, P<0.001). The abdominal branch arteries involved by false lumen was also deceased in PCC group. There was also a lower serum inflammation response (24 hours, hr-CRP: 111.8±14.1mg/L vs. 116.8±15.0mg/L, P=0.002; IL-6: 104.4±49.9pg/ml vs. 124.0±50.1pg/ml, P<0.001), anaerobic metabolism (8 hours, lactate: 8.3±1.5mmol/L vs. 8.8±1.6mmol/L, P=0.002), impaired liver function (15.5% vs. 39.8%, P<0.001) and need for renal replacement therapy (10.3% vs. 20.5%, P=0.012) in PCC group than those in PC group. Conclusion: Interactive cannulation with prompt transition from peripheral artery to centric perfusion during surgical repair of AAD was associated with the reduction of MFLA and hepatorenal dysfunction.

Source: Journal of Cardiovascular and Thoracic Research

Authors: Qin Jiang, Shanshan Lin, Xiaoxiao Gou, Tao Yu, Keli Huang, Shengshou Hu

Institutions: University of Electronic Science and Technology of China, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Fu Wai Hospital

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4412781518

FWCI:

Cites: 25

Cited by:

Related to: 10