B Milicic

D Cvetkovic

Lj Soskic

M Kocica

M Ristic

N Aleksic

Journal of Cardiothoracic Surgery

PubMed

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ORAL PRESENTATION Open Access
Open distal anastomosis technique in acute type
A aortic dissection
D Cvetkovic1*, M Kocica1, Lj Soskic1, B Milicic2, N Aleksic1, M Ristic1
From 23rd World Congress of the World Society of Cardio-Thoracic Surgeons
Split, Croatia. 12-15 September 2013
Background
Acute ascending aortic dissections is the most common
catastrophe of the aorta that requires emergency surgery.
There is still a debate regarding the optimal surgical
approaches for construction of the distal anastomosis in
replacing the ascending aorta. The purpose of this study
was to evaluate early clinical outcomes of two different
surgical techniques: open distal anastomosis in hypother-
mic circulatory arrest (OHCA) compared to anastomosis
with clamped aorta while continuing on extracorporeal
circulation (CECC).
Methods
A prospective randomized study in 84 consecutive patients
who were operated, between September 2008 and Septem-
ber 2010, for acute type A aortic dissection with isolated
replacement of the ascending aorta. The influence of two
techniques (OHCA n = 35, CECC n = 49) on clinical out-
come was investigated.
Results
No significant difference was found between the two
groups in terms of age and sex distribution. The groups
were comparable with respect to all preoperative and
intraoperative predictive risk factors for early clinical out-
come and complications. The mean period of circulatory
arrest lasted 30,46 min (15-61 min) at an average naso-
pharyngeal temperature of 23.57°C (16-28°C). Treatment
method (OHCA vs CECC) was not associated with differ-
ences in intrahospital mortality (28.6% vs 26.5%, p=0,836)
nore in early major postoperative complications: de novo
focal neurolocigal deficits (11.4% vs 10.2%, p=0,858), acute
renal failure (8.6% vs 10.2, p=0,802), blood loss
(1289.71 ml vs 1126.12 ml, p=0,892) or reexploration for
hemorrhage (8.6% vs 8.2%, p=0,947).
Conclusion
While there is no difference in clinical outcome in surgical
treatment of acute type A aortic dissection with or without
circulatory arrest, there are some practical technical
advantages if the distal anastomosis is performed in an
open manner. Probably the long-term outcome would also
be better with this anastomosis technique.
Authors’ details
1Clinic for Cardiac Surgery, UC Clinical Centre of Serbia, Belgrade, Serbia.
2Clinic for Cardiology, UC Clinical Centre of Serbia, Belgrade, Serbia.
Published: 11 September 2013
doi:10.1186/1749-8090-8-S1-O15
Cite this article as: Cvetkovic et al.: Open distal anastomosis technique
in acute type A aortic dissection. Journal of Cardiothoracic Surgery 2013
8(Suppl 1):O15.
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* Correspondence: d.cvetkovic@sezampro.rs
1Clinic for Cardiac Surgery, UC Clinical Centre of Serbia, Belgrade, Serbia
Full list of author information is available at the end of the article
Cvetkovic et al. Journal of Cardiothoracic Surgery 2013, 8(Suppl 1):O15
http://www.cardiothoracicsurgery.org/content/8/S1/O15
© 2013 Cvetkovic et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.


Open distal anastomosis technique in acute type A aortic dissection

http://dx.doi.org/10.1186/1749-8090-8-S1-O15

Open distal anastomosis technique in acute type A aortic dissection

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