Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection

Abstract Background and objective Acute type A aortic dissection (ATAAD) is a critical and life-threatening condition. To date, surgical intervention remains the primary life-saving treatment. However, this surgical approach is often accompanied by a range of postoperative complications, and the ass...

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Main Authors: Zulei Zhang, Longren Cai, Fengwen Zhong, Xinghua Peng, Zhanghong Li, Yunfei Liao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-03052-y
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author Zulei Zhang
Longren Cai
Fengwen Zhong
Xinghua Peng
Zhanghong Li
Yunfei Liao
author_facet Zulei Zhang
Longren Cai
Fengwen Zhong
Xinghua Peng
Zhanghong Li
Yunfei Liao
author_sort Zulei Zhang
collection DOAJ
description Abstract Background and objective Acute type A aortic dissection (ATAAD) is a critical and life-threatening condition. To date, surgical intervention remains the primary life-saving treatment. However, this surgical approach is often accompanied by a range of postoperative complications, and the associated mortality rate remains high. In this study, we introduced an innovative technique that utilized tetrafurcate graft eversion for suturing and reinforcing the aortic root, in conjunction with a single-branched stent technique, for the management of ATAAD. Method A total of eighty-nine ATAAD patients who underwent surgical treatment at Ganzhou People’s Hospital between January 2021 and March 2024 were enrolled in this study. The patients were divided into two groups based on the surgical technique employed: a conventional group (n = 57) and an modified-technique group (n = 32). A comprehensive analysis of perioperative outcomes was conducted. Results There were no statistically significant differences in preoperative characteristics between the two groups. The intraoperative cardiopulmonary bypass (CPB) time, assisted-circulation time (ACT), and total operation time in the modified-technique group were significantly shorter than those in the conventional group (P = 0.027, P = 0.009, and P = 0.012, respectively). Moreover, patients in the modified-technique group had less drainage on the first postoperative day (P = 0.011), shorter ventilation time, intensive care unit (ICU) stay, and postoperative in-hospital stay (P = 0.014, P = 0.028, and P = 0.017, respectively), as well as a lower postoperative in-hospital mortality rate (P = 0.035)​. Conclusion Combining tetrafurcate graft eversion for aortic root suturing and reinforcement with single-branched stent implantation offers a simplified, safe, and effective approach for treating ATAAD.
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spelling doaj-art-b9f4796da2dc4ceeb62260f86f76bed22025-08-20T03:42:37ZengBMCBMC Surgery1471-24822025-07-012511910.1186/s12893-025-03052-yTetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissectionZulei Zhang0Longren Cai1Fengwen Zhong2Xinghua Peng3Zhanghong Li4Yunfei Liao5Department of cardiovascular surgery, Ganzhou People’s Hospital (Southern Hospital Affiliated Ganzhou Hospital)Department of cardiovascular surgery, Ganzhou People’s Hospital (Southern Hospital Affiliated Ganzhou Hospital)Department of cardiovascular surgery, Ganzhou People’s Hospital (Southern Hospital Affiliated Ganzhou Hospital)Department of cardiovascular surgery, Ganzhou People’s Hospital (Southern Hospital Affiliated Ganzhou Hospital)Department of cardiovascular surgery, Ganzhou People’s Hospital (Southern Hospital Affiliated Ganzhou Hospital)Department of cardiovascular surgery, Ganzhou People’s Hospital (Southern Hospital Affiliated Ganzhou Hospital)Abstract Background and objective Acute type A aortic dissection (ATAAD) is a critical and life-threatening condition. To date, surgical intervention remains the primary life-saving treatment. However, this surgical approach is often accompanied by a range of postoperative complications, and the associated mortality rate remains high. In this study, we introduced an innovative technique that utilized tetrafurcate graft eversion for suturing and reinforcing the aortic root, in conjunction with a single-branched stent technique, for the management of ATAAD. Method A total of eighty-nine ATAAD patients who underwent surgical treatment at Ganzhou People’s Hospital between January 2021 and March 2024 were enrolled in this study. The patients were divided into two groups based on the surgical technique employed: a conventional group (n = 57) and an modified-technique group (n = 32). A comprehensive analysis of perioperative outcomes was conducted. Results There were no statistically significant differences in preoperative characteristics between the two groups. The intraoperative cardiopulmonary bypass (CPB) time, assisted-circulation time (ACT), and total operation time in the modified-technique group were significantly shorter than those in the conventional group (P = 0.027, P = 0.009, and P = 0.012, respectively). Moreover, patients in the modified-technique group had less drainage on the first postoperative day (P = 0.011), shorter ventilation time, intensive care unit (ICU) stay, and postoperative in-hospital stay (P = 0.014, P = 0.028, and P = 0.017, respectively), as well as a lower postoperative in-hospital mortality rate (P = 0.035)​. Conclusion Combining tetrafurcate graft eversion for aortic root suturing and reinforcement with single-branched stent implantation offers a simplified, safe, and effective approach for treating ATAAD.https://doi.org/10.1186/s12893-025-03052-yATAADTetrafurcate graft Eversion suturingSingle-branched stentCPBSurgery
spellingShingle Zulei Zhang
Longren Cai
Fengwen Zhong
Xinghua Peng
Zhanghong Li
Yunfei Liao
Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection
BMC Surgery
ATAAD
Tetrafurcate graft Eversion suturing
Single-branched stent
CPB
Surgery
title Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection
title_full Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection
title_fullStr Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection
title_full_unstemmed Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection
title_short Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection
title_sort tetrafurcate graft eversion suturing combined with single branched stent technique in surgical repair of acute type a aortic dissection
topic ATAAD
Tetrafurcate graft Eversion suturing
Single-branched stent
CPB
Surgery
url https://doi.org/10.1186/s12893-025-03052-y
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