Extra-anatomic revascularization and a new cannulation strategy for preoperative cerebral malperfusion due to severe stenosis or occlusion of supra-aortic branch vessels in acute type A aortic dissection

• DOI: 10.1016/j.heliyon.2023.e18251
• Publication Date: 2023-07-15T01:35:39Z
• Authors: Jingwei Sun; Chao Xue; Jinglong Zhang; Chen Yang; Kai Ren; Hanzhao Zhu; Bin Zhang; Xiayun Li; Hongliang Zhao; Zhenxiao Jin; Jincheng Liu; Weixun Duan
• Keywords: Interquartile range

ObjectivesAcute type A aortic dissection (ATAAD) with severe stenosis or occlusion of the true lumen arch branch vessels often leads to an increased incidence postsurgical neurological complications and mortality rate. In this study, we aimed introduce our institutional extra-anatomic revascularization cannulation strategy improved postoperative outcomes for better management patients cerebral malperfusion in setting ATAAD.MethodsTwenty-eight ATAAD complicated by vessels, as noted on combined computed tomography angiography aorta craniocervical artery, between January 2021 June 2022 were included study. Basic patient characteristics, surgical procedures, hospitalization stays, early follow-up results analyzed.ResultsThe median duration was 16.5 months (interquartile range: 11.5–20.5), a 100% completion The 30-day rates 7.1% (2/28 patients); two had multiple infarctions preoperative persistent coma. Postoperative transient dysfunction occurred 10.7% (3/28) patients, no new permanent occurred. Of all 3.6% (1/28) novel acute renal failure. No other deaths, secondary surgeries, serious during period.ConclusionsUse before cardiopulmonary bypass is safe feasible may reduce high malperfusion.