The aim of this study was to show a technique and the results of the 60-day survival rate under treatment of acute type A aortic dissection by transapical aortic cannulation technique.
The data has been investigated from 12 years of surgery experience since June 2003 in acute type A acute aortic dissection by transapical aortic cannulation technique. This study was approved and reviewed by the ethical committee of the Kawasaki Saiwai Hospital, Kawasaki, Japan. Statistical analysis: Cox proportional hazard regression was employed to analyze risk ratio, and Kaplan Meier curve was used to estimate the survival time. p < 0.05 was considered statistically significant.
The study population (n = 309) was investigated for survival analysis. The person-time was 6363.50 person/months. We found that, the death outcome was 29 persons (9.38%). The mortality rate was 4.55/1000 person/months (95% Confidence Interval = 3.17-6.56/1000 person-month)
Risk factors influencing the survival rate in acute type A aortic dissection included coronary artery disease, preoperative hemodynamic deterioration, total arch replacement, cardiopulmonary bypass technique using only deep hypothermic circulatory arrest, deep hypothermic circulatory arrest with retrograde cerebral perfusion and deep hypothermic circulatory arrest with antegrade selective cerebral perfusion. The enlargement of ascending aortic diameter and proximal descending aorta diameter increased the death rate by 11% and 18%, respectively. Each time the diameter expanded 1 mm, and the operation time extended by 1 minute, the death rate was increased by 1%.
acute type A aortic dissection, transapical aortic cannulation technique, deep hypothermic circulatory arrest