Journal of thoracic disease · 2025
Analysis of the effect of Preset Cabrol in total arch replacement for type A aortic dissection.
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Cai Zhixiang, Yan Tao, Zhang Ben, Su Chenjie, Zhang Hongbin, Zhang Weida, Wang Xianyue
Аннотация
BACKGROUND: Hemostasis can be challenging after ascending aorta replacement and Sun's procedure. This study aims to assess the impact of employing the Preset Cabrol technique during these procedures.
METHODS: A retrospective analysis was conducted on 258 consecutive patients diagnosed with type A aortic dissection (TAAD) who underwent ascending aortic replacement and Sun's procedure between January 2021 and January 2024. The patients were divided into two groups: the preset group (n=203) and the control group (n=55).
RESULTS: There were no significant differences between the groups in terms of 30-day mortality (preset: 6.9% vs. control: 7.3%, P=0.92) and aortic cross-clamp time [preset: 64.9±12.3 minutes (range, 51-106 minutes) vs. control: 63.5±13.1 minutes (range, 45-138 minutes), P=0.48]. However, the preset group demonstrated significantly shorter operation time [298.6±48.4 minutes (range, 251-410 minutes) vs. control: 365.6±75.3 minutes (range, 248-605 minutes)] and cardiopulmonary bypass (CPB) time [119.8±15.3 minutes (range, 88-148 minutes) vs. control: 148.5±41.8 minutes (range, 86-225 minutes)] (P<0.001). Additionally, the preset group required fewer blood product transfusions, had shorter mechanical ventilation durations (P=0.049), and incurred lower total hospitalization costs (P=0.02). No persistent shunts or complications related to thrombus accumulation were observed during postoperative follow-up.
CONCLUSIONS: The Preset Cabrol technique is proven to be a valuable tool during ascending aortic replacement and Sun's procedure. It effectively controls bleeding, leading to reduced CPB and operation times, decreased blood product transfusion, and lower hospitalization costs.
METHODS: A retrospective analysis was conducted on 258 consecutive patients diagnosed with type A aortic dissection (TAAD) who underwent ascending aortic replacement and Sun's procedure between January 2021 and January 2024. The patients were divided into two groups: the preset group (n=203) and the control group (n=55).
RESULTS: There were no significant differences between the groups in terms of 30-day mortality (preset: 6.9% vs. control: 7.3%, P=0.92) and aortic cross-clamp time [preset: 64.9±12.3 minutes (range, 51-106 minutes) vs. control: 63.5±13.1 minutes (range, 45-138 minutes), P=0.48]. However, the preset group demonstrated significantly shorter operation time [298.6±48.4 minutes (range, 251-410 minutes) vs. control: 365.6±75.3 minutes (range, 248-605 minutes)] and cardiopulmonary bypass (CPB) time [119.8±15.3 minutes (range, 88-148 minutes) vs. control: 148.5±41.8 minutes (range, 86-225 minutes)] (P<0.001). Additionally, the preset group required fewer blood product transfusions, had shorter mechanical ventilation durations (P=0.049), and incurred lower total hospitalization costs (P=0.02). No persistent shunts or complications related to thrombus accumulation were observed during postoperative follow-up.
CONCLUSIONS: The Preset Cabrol technique is proven to be a valuable tool during ascending aortic replacement and Sun's procedure. It effectively controls bleeding, leading to reduced CPB and operation times, decreased blood product transfusion, and lower hospitalization costs.