Key result
Trifurcated branch graft technique for total arch replacement in type A aortic dissection had similar 30-day mortality compared to the island technique (9.83% vs 8.33%; p=0.815).
Why the study?
Outcomes between the trifurcated graft and island technique for total arch replacement in type A aortic dissection needed comparison.
Does the trifurcated branch graft technique compared to the island technique improve outcomes in patients undergoing total arch replacement for type A aortic dissection?
Cohort (n=87)
No
Does the trifurcated branch graft technique compared to the island technique improve outcomes in patients undergoing total arch replacement for type A aortic dissection?
Absolute Event Rate: 9.83% vs 8.33%
p-value: p=0.815
Both trifurcated branch graft and island techniques yield comparable 30-day mortality for type A aortic dissection, though the trifurcated technique requires longer procedural times.
Comparable outcomes support surgeon preference in type A dissection; leaves open need for randomized trials.
Objective To compare the outcome between trifurcated graft vs island technique for the treatment of type A aortic dissection in a single centre. Method From september 2017 to september 2020, we studied 87 patients retrospectively, who underwent total arch replacement for type A aortic dissection. Out of which 51 patients, age (47.45 ± 10.47) years, 39(76.47%) males and 12 (23.52%) females were surgically corrected by trifurcated branch graft technique and 36 patients age (52.75 ± 10.32) years, 27 (75%) males and 9 (25%) females with island technique. In both the groups, peri- operative outcomes were compared. Patients were followed up for 3 months and 6 months in both the groups. Result Elective Surgery was done in 16 (31.37%) and 6 (16.66%) in trifurcated branch graft and island group respectively. Selective antegrade cerebral perfusion (SACP) was given by the Axillary artery in {48 (94.11%) in trifurcated group and 3 (8.33%) in island group, p=<.00001}.SACP was given by Innominate artery {5 (9.83%) in trifurcated group and 33 (91.66%) in island group, p=<.00001}. Trifurcated branch group and Island group had Cardiopulmonary Bypass time, cross clamp time, total circulatory arrest time of (245 ± 33.30), (117.62 ± 29.38), (54.33 ± 13.19) min and (195.88 ± 32.83), (70.11 ± 20.62), (33.52 ± 8.683) (p=<.00001); respectively. 30 day mortality was 5(9.83%) in trifurcated group and 3 (8.33%) in island group (p=0.815). Conclusion Trifurcated branched graft and island technique, have comparable results, only prerequisite being surgeons comfortability and experience. Trifurcated branch graft being associated with longer CPB, cross clamp and circulatory arrest time, but with no difference in overall adverse outcomes or mortality.
No takes yet. Share an insight, caveat, or question.
Inamdar et al. (2022) conducted a cohort in Type A aortic dissection (n=87). Trifurcated branch graft technique vs. Island technique was evaluated on 30 day mortality (p=0.815). Trifurcated branch graft technique for total arch replacement in type A aortic dissection had similar 30-day mortality compared to the island technique (9.83% vs 8.33%; p=0.815).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: