Analysis of early death factors after surgical treatment for Stanford type A aortic dissection

Objective To analyze the treatment process and outcome of patients with Stanford A aortic dissection and summarize the experience of surgical treatment.

Methods Retrospective analysis was performed on the surgical data, treatment plan and prognosis of 51 cases with Stanford type A aortic dissection.Patients were divided into death group and nondeath group according to whethe they died or not.

Results Compared with the non-death group, patients in the death group were significantly involved in the aortic root, the aorta occlusion time was longer, the intraoperative blood transfusion volume was higher, more postoperative adjuvant therapy was required with CRRT and ECMO, and the stay time in ICU and hospitalization time were longer(P < 0.05 to P < 0.01).Multiple regression analysis of causes of death suggested that aortic root involvement, postoperative CRRT and ECMO were correlated with death(OR=9.714, 8.831 and 10.997, P < 0.05).

Conclusions Emergency surgery is the most effective treatment for Stanford A aortic dissection.Root "sandwich" technique is an effective method for root bleeding and aortic valve insufficiency.The hemostasis of distal and proximal segments of aorta is the key to the success of the operation.