An observational study in Type A Aortic Dissection, sponsored by First Affiliated Hospital Xi'an Jiaotong University. Completed at 1 site in China. Per ClinicalTrials.gov, last updated 2023-08-09.
Sponsored by First Affiliated Hospital Xi'an Jiaotong University · Observational
This is a retrospective study based on the data available in our hospital database for ATAAD patients from January 2020 to December 2021. These patients were divided into two groups according to the surgical procedures of aortic root. This study compared baseline data, perioperative and short-term follow-up results between the two groups to evaluate the efficacy and safety of XJ-procedure in ATAAD.
Acute type A aortic dissection (ATAAD) is a life-threatening disease with high mortality. Surgery remains the gold standard for the treatment of ATAAD. In recent years, ATAAD is still a persistent challenge for cardiovascular surgeons. This is a retrospective study based on the data available in our hospital database for ATAAD patients undergoing total aortic arch replacement with elephant trunk stent under cryogenic stop circulation from January 2020 to December 2021. These patients were divided into two groups according to the surgical procedures of aortic root: continuous aortic root suture group (CARS group); "aortic root reinforcement combined with vascular grafts eversion and built-in", which was created by our group and to be named as XJ-procedure (XJ-procedure group, XJ is an acronym for Xi'an Jiaotong University). The main outcome was defined as 30-day mortality. Secondary outcomes included the postoperative bleeding necessitating re-operation and the incidence of anastomotic pseudoaneurysm, residual aortic root dissection and severe aortic regurgitation before discharge and at 3 and 6 months after the operation. This study compared baseline data, perioperative and short-term follow-up results between the two groups to evaluate the efficacy and safety of XJ-procedure in ATAAD.
386 studies on the registry are indexed under Aortic Dissection; 117 are open to participants now.
This study's enrollment of 183 is close to the median of 183 across 180 observational studies indexed under Aortic Dissection.
Browse Aortic Dissection studies →First Affiliated Hospital Xi'an Jiaotong University is the lead sponsor of 306 studies on the registry; 86 are open to participants now.
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The study enrolled patients who were diagnosed with ATAAD by computed tomography angiography (CTA) from January 2020 to December 2021 in the First Affiliated Hospital of Xi'an Jiaotong University. Inclusion criteria included mild to moderate aortic root involvement, combined with aortic arch involvement undergoing Sun's procedure. The exclusion criteria included severe aortic root involvement (root diameter >45 mm, root tear, severe disruption of aortic root, concomitant valve disease); the Bentall, Wheat or David procedure performed; recurrent ATAAD; preoperative severe brain complications (cerebral infarction, cerebral hemorrhage, coma, etc.), mal-perfusion of abdominal organs or lower extremities >12 h and incomplete clinical data.
Exclusion Criteria:
In the CARS group, 3-0 polypropylene was used to suture the proximal end of aortic with the vascular grafts continuously, followed by one interrupted suture loop of 3-0 polypropylene for reinforcement.
Other: No Intervention.
In the XJ-procedure group, a 1.5-2cm wide bovine pericardial patch and graft ring were placed inside and outside the aortic root and against the aortic wall, respectively, and continuously sutured near the commissure using 5-0 polypropylene. Then an eversion about 15mm of vascular graft was intermittently sutured to full layers of aortic vascular with 2-0 pad polyester sutures. Finally, the eversion and aortic wall were continuously sutured together in one more turn.
Other: No Intervention.
No Intervention.
30-day mortality
Patients died within 30 days after the surgery. Data were obtained from the medical records.
Time frame: Within 30 days after the surgery
The postoperative bleeding necessitating re-operation
Postoperative bleeding necessitated reoperation during hospitalization. Data were obtained from the surgical records and medical records.
Time frame: About 2 weeks after the surgery.
Change in the incidence of anastomotic pseudoaneurysm
The occurrence of anastomotic pseudoaneurysm was examined by postoperative computed tomography angiography examination.
Time frame: About 2 weeks after surgery, 3-month and 6-month follow-up.
Change in the incidence of residual aortic root dissection
The occurrence of residual aortic dissection was examined by postoperative computed tomography angiography examination.
Time frame: About 2 weeks after surgery, 3-month and 6-month follow-up.
Change in the incidence of severe aortic regurgitation
The occurrence of aortic valve regurgitation greater than grade2+, which was decided by cardiac ultrasonography.
Time frame: About 2 weeks after surgery, 3-month and 6-month follow-up.
Plan to share: No
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This study is completed, as verified in Aug 2023. You cannot join it, but the record below documents what was studied.
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First Affiliated Hospital Xi'an Jiaotong University