Key result
Aortic sinus reconstruction with patches for acute type A dissection shows ~6% in-hospital mortality.
Why the study?
Acute type A aortic dissection involving the aortic sinus often features aortic regurgitation despite an undamaged aortic valve structure, prompting evaluation of aortic sinus reconstruction using patches.
Does aortic sinus reconstruction using patches improve clinical outcomes in patients with acute type A aortic dissection involving the aortic sinus?
Observational (n=52)
Does aortic sinus reconstruction using patches improve clinical outcomes in patients with acute type A aortic dissection involving the aortic sinus?
Aortic sinus reconstruction using patches is a feasible and effective method for aortic valve-sparing root reconstruction in acute type A aortic dissection, with favorable mid-term outcomes.
Patch reconstruction may be considered for sinus involvement in acute type A dissection; leaves open need for randomized trials on durability.
OBJECTIVES: Acute type A aortic dissection involving the aortic sinus is often combined with varying degrees of aortic regurgitation, while the structure of the aortic valve is often undamaged. The aim of this study was to evaluate the clinical effects of reconstruction of the aortic sinus using patches in patients with acute type A aortic dissection. METHODS: From January 2016 to December 2019, 52 patients with acute type A aortic dissection involving the aortic sinus were treated with aortic sinus reconstruction using pericardial or artificial vascular patches. The clinical and follow-up data were summarized. RESULTS: Bovine pericardial patches were used in 31 cases and artificial vascular patches were used in 21 cases for aortic sinus reconstruction. Cardiopulmonary bypass time was (250.4 ± 65.7) min, aortic cross clamp time was (143.7 ± 42.3) min, and hypothermic circulatory arrest time was (9.6 ± 8.1) min. Three patients died in hospital, with a mortality rate of 5.8%. Fifteen patients (28.8%) had mild postoperative aortic regurgitation. The follow-up duration was 40 ± 12 (range, 21-66) months. Five patients (10.2%) developed moderate to severe aortic regurgitation and 3 (6.1%) died during the follow-up period. CONCLUSIONS: The application of patches for aortic sinus reconstruction is a relatively easy method in aortic valve-sparing root reconstruction for acute type A aortic dissection involving the aortic sinus. The clinical and follow-up results are favorable.
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Zou et al. (2022) conducted an observational in Acute type A aortic dissection involving the aortic sinus (n=52). Aortic sinus reconstruction using pericardial or artificial vascular patches was evaluated on In-hospital mortality. Aortic sinus reconstruction using patches for acute type A aortic dissection resulted in a 5.8% in-hospital mortality rate and a 10.2% rate of moderate to severe aortic regurgitation over 40 months.
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