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Journal of Medical Sciences MEDLINEScopus

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篇名 Comparison of Vascular Ring Connector and Conventional Suture Technique in the Surgical Management of Acute Type A Aortic Dissection
卷期 36:5
作者 Yuan‑Hao LiuHung‑Yen KePo‑Shun HsuYi‑Chang LinYi‑Ting TsaiSheng‑Tang WuYu‑Ju ChenChia‑Sheng ChaoHsien‑Kuo ChinChih‑Yuan LinChien‑Sung Tsai
頁次 188-193
關鍵字 Conventional suturevascular ring connectoracute type A aortic dissectionsurgical outcomesMEDLINEScopus
出刊日期 201610
DOI 10.4103/1011-4564.192827

中文摘要

英文摘要

Background: The aim of this study was to examine the utility of the vascular ring connector (VRC) and compare the clinical outcomes to conventional suture technique in the operation for acute type A aortic dissection (AAAD). Methods: We retrospectively enrolled 64 consecutive patients (mean age 57.4 ± 12.7 years, range 24–82 years) with AAAD who underwent emergent surgery in our institution from September 2010 to November 2014. Patients were divided into VRC group (55 patients) and conventional suture group (nine patients) based on the use of VRC during the operation. The preoperative characteristics, operative variables, and postoperative outcomes were collected and analyzed. Results: Male patients predominated in both groups. The mean times of cardiopulmonary bypass and aortic cross‑clamp were 200.1 ± 99.9 and 193.6 ± 54.7 min (P = 0.425) and 107.5 ± 56.2 and 112.3 ± 40.8 min (P = 0.404) in the VRC group and suture group, respectively. There were more blood transfusions within 24 h (1513.3 ± 949.2 vs. 841.8 ± 801.1 ml) and more mediastinal drainage amount (1314.4 ± 650.3 ml vs. 942.1 ± 527.2 ml) in the suture group than in the VRC group. In the VRC group, 36.3% of patients did not require blood transfusion. Moreover, the pumping time and cardiac ischemic times were longer in the one‑VRC group than in the two‑VRC group. Operative mortality did not differ between the two groups (10.9% in VRC and 11.1% in suture group, P = 0.985). No dislodgement of VRC during or after operation and no bleeding from sutureless anastomosis site were noted. Conclusion: Use of VRC is associated with equivalent operative mortality and morbidity compared to suture group in patients with AAAD undergoing an emergent operation. This study demonstrates the clinical safety and efficacy of VRC in reducing the need of blood transfusion within 24 h and mediastinal drainage within 72 h. However, further randomized studies and long‑term surveillance of the use of VRC in AAAD are still mandatory.

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