Rupture-oriented strategy for acute type A aortic dissection

D.V. Kuznetsov

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-4843-4679

A.P. Semagin

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-2945-894X

A.A. Zybin

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0001-8985-5723

A.A. Gevorgyan

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-0730-4608

M.V. Polyaeva

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-3305-5318

N.N. Sidorenko

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-2538-3573

S.M. Khokhlunov

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0001-6000-620X

Rupture-oriented strategy for acute type A aortic dissection

Authors:

D.V. Kuznetsov, A.P. Semagin, A.A. Zybin, A.A. Gevorgyan, M.V. Polyaeva, N.N. Sidorenko, S.M. Khokhlunov

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(1): 56‑62

DOI: 10.17116/kardio20241701156

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To cite this article:

Kuznetsov DV, Semagin AP, Zybin AA, Gevorgyan AA, Polyaeva MV, Sidorenko NN, Khokhlunov SM. Rupture-oriented strategy for acute type A aortic dissection. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(1):56‑62. (In Russ., In Engl.)
https://doi.org/10.17116/kardio20241701156

Доказательная гастроэнтерология: pro et contra

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OBJECTIVE

To evaluate the immediate and long-term results of surgical treatment of acute aortic dissection type A using rupture-oriented strategy.

MATERIAL AND METHODS

A prospective study included 157 patients with acute aortic dissection type A who were divided into 2 groups: group 1 — 123 people (inner wall rupture in ascending aorta or lesser curvature of aortic arch) underwent ascending aorta replacement and, if necessary, hemiarch procedure, group 2 — 34 patients (inner wall rupture in aortic arch (except for lesser curvature) or no rupture in ascending aorta and aortic arch, aortic arch aneurysm) underwent ascending aorta and aortic arch replacement. Early and late postoperative results were assessed.

RESULTS

In-hospital mortality was similar (13.8% and 14.7%, respectively, p=0.9). Early postoperative morbidity (bleeding, myocardial infarction, neurological complications, acute renal failure) was similar. Five-year survival rate was 74% and 82%, respectively (p=0.97), five-year freedom from redo aortic surgery — 88% and 90%, respectively (p=0.75).

CONCLUSION

Rupture-oriented surgical strategy for acute aortic dissection type A may be used without worsening immediate and long-term results, especially in hospitals without extensive experience in aortic surgery.

Keywords:

aortic dissection

ascending aorta replacement

aortic arch replacement

Authors:

D.V. Kuznetsov

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-4843-4679

A.P. Semagin

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-2945-894X

A.A. Zybin

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0001-8985-5723

A.A. Gevorgyan

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-0730-4608

M.V. Polyaeva

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-3305-5318

N.N. Sidorenko

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0003-2538-3573

S.M. Khokhlunov

Polyakov Regional Clinical Cardiology Dispensary

ORCID: 0000-0001-6000-620X

Received:

31.08.2022

Accepted:

21.10.2022

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