Contemporary strategies to the level of distal anastomosis formation for patients with acute DeBakey type I aortic dissection (literature review and own view on the problem)
AbstractThe article presents the data of domestic and foreign literature on the surgical treatment of DeBakey type I acute aortic dissection, as one of the most challenging pathologies in the practice of a cardiac surgeon. Unfavorable nature of the disease, a variation in presentation and clinical course along with an urgent treatment require significant attentiveness. A unified concept of treatment is practically excluded due to the variety of surgical approaches, clinical experience and interventions. There have been demonstrated approaches to surgical treatment and level of a distal anastomosis formation including simple clamp on operations only on the ascending aorta to total arch replacement with hybrid-techniques and their combination in the form of proximalization of the distal anastomosis zone. The clinic’s own vision of this problem is also presented.
Funding. The study had no financial support.
Conflict of interest. The authors declare no conflicts of interest.
Authors’ contribution. Study conception and design – Selyaev V.S.; data collection and handling – Selyaev V.S.; draft manuscript preparation – Selyaev V.S.; manuscript revision – Redkoborody A.V.
For citation: Selyaev V.S., Redkoborody A.V. Contemporary strategies to the level of distal anastomosis formation for patients with acute DeBakey type I aortic dissection (literature review and own view on the problem). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2023; 29 (3): 140–7. DOI: https://doi.org/10.33029/1027-6661-2023-29-3-140-147 (in Russian)
Keywords: acute aortic dissection; distal anastomosis; ascending aorta; aortic arch; proximalization anastomosis
References
1. Conzelmann L.O., Weigang E., Mehlhorn U., et al.; GERAADA Investigators. Mortality in patients with acute aortic dissection type A: Analysis of pre- and intraoperative risk factors from the German Registry for Acute Aortic Dissection Type A (GERAADA). European Journal of Cardio-Thoracic Surgery. 2016; 49 (2): e44–52. DOI: https://doi.org/10.1093/ejcts/ezv356
2. Lee T.C., Kon Z., Cheema F.H., et al. Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database. Journal of Cardiac Surgery. 2018; 33 (1): 7–18. DOI: https://doi.org/10.1111/jocs.13511
3. Pan E., Gudbjartsson T., Ahlsson A., et al. Low rate of reoperations after acute type A aortic dissection repair from The Nordic Consortium Registry. Journal of Thoracic and Cardiovascular Surgery. 2018; 156 (3): 939–948. DOI: https://doi.org/10.1016/j.jtcvs.2018.03.144
4. Rukosujew A., Usai M.V., Martens S., et al. Present-day policy of surgical treatment for type A acute aortic dissection. Angiology and Vascular Surgery. 2020; 26 (3): 82–91. DOI: https://doi.org/10.33529/ANGIO2020217 (in Russian)
5. Gordeev M.L., Uspensky V.E., Bakanov A.Yu., et al. Reconstructive interventions on the aortic arch in the surgical treatment of aneurysms and dissections of the ascending aorta. Pathology of blood circulation and cardiac surgery. 2016; 20 (4): 45–57. DOI: https://doi.org/10.21688/1681-3472-2016-4-45-57 (in Russian)
6. Rosinski B.F., Idrees J.J., Roselli E.E., et al. Cannulation strategies in acute type A dissection repair: A systematic axillary artery approach. Journal of Thoracic and Cardiovascular Surgery. 2019; 158 (3): 647–659.e5. DOI: https://doi.org/10.1016/j.jtcvs.2018.11.137
7. Frankel W.C., Green S.Y., Orozco–Sevilla V., et al. Contemporary Surgical Strategies for Acute Type A Aortic Dissection. Seminars in Thoracic and Cardiovascular Surgery. 2020; 32 (4): 617–629. DOI: https://doi.org/10.1053/j.semtcvs.2020.06.025
8. Yamamoto H., Kadohama T., Yamaura G., et al. Total arch repair with frozen elephant trunk using the “zone 0 arch repair” strategy for type A acute aortic dissection. Journal of Thoracic and Cardiovascular Surgery. 2019; 219: S0022-5223(19)30360-5. DOI: https://doi.org/10.1016/j.jtcvs.2019.01.125
9. Czerny M., Siepe M., Beyersdorf F., et al. Prediction of mortality rate in acute type A dissection: the German Registry for Acute Type A Aortic Dissection score. European Journal of Cardio-Thoracic Surgery. 2020; 58 (4): 700–706. DOI: https://doi.org/10.1093/ejcts/ezaa156
10. Evangelista A., Isselbacher E.M., Bossone E., et al; IRAD Investigators. Insights from the International Registry of Acute Aortic Dissection: a 20-year experience of collaborative clinical research. Circulation. 2018; 137 (17): 1846–1860. DOI: https://doi.org/10.1161/CIRCULATIONAHA.117.031264
11. Malaisrie S.C., Szeto W.Y., Halas M., et al.; AATS Clinical Practice Standards Committee: Adult Cardiac Surgery. 2021 The American Association for Thoracic Surgery expert consensus document: Surgical treatment of acute type A aortic dissection. Journal of Thoracic and Cardiovascular Surgery. 2021; 162 (3): 735–758.e2. DOI: https://doi.org/10.1016/j.jtcvs.2021.04.053
12. Geirsson A., Shioda K., Olsson C., et al. Differential outcomes of open and clamp-on distal anastomosis techniques in acute type A aortic dissection. Journal of Thoracic and Cardiovascular Surgery. 2019; 157 (5): 1750–1758. DOI: https://doi.org/10.1016/j.jtcvs.2018.09.020
13. Lawton J.S., Liu J., Kulshrestha K., et al. The impact of surgical strategy on survival after repair of type A aortic dissection. Journal of Thoracic and Cardiovascular Surgery. 2015; 150 (2): 294–301.e1. DOI: https://doi.org/10.1016/j.jtcvs.2015.03.023
14. Malvindi P.G., Modi A., Miskolczi S., et al. Open and closed distal anastomosis for acute type A aortic dissection repair. Interactive CardioVascular and Thoracic Surgery. 2016; 22 (6): 776–783. DOI: https://doi.org/10.1093/icvts/ivw044
15. Latt K.K., Vasiliyev K.N., Bayandin N.L., Stupin V.A. Risk factors of surgical treatment of acute aortic dissection type A. Pirogov Russian Journal of Surgery. 2019; 3 (1): 15–20. DOI: https://doi.org/10.17116/hirurgia201903115 (in Russian)
16. Rubtsov N.V., Sokolov V.V., Redkoborodyi A.V., Selyaev V.S. Ways to reduce hospital mortality in patients with “acute” aortic dissection of type A. Cardiovascular diseases. Bulletin of the A.N. Bakulev National Agricultural Academy of the Russian Academy of Sciences 2019; 20 (11 Suppl.): 43. (in Russian)
17. Redkoborody A.V., Selyaev V.S., Rubtsov N.V., et al. The Choice of Tactics for Surgical Treatment of Acute De Bakey Type I Aortic Dissection in a Multidisciplinary Surgical Hospital. Russian Sklifosovsky Journal of Emergency Medical Care. 2023; 12 (1): 14–22. DOI: https://doi.org/10.23934/2223-9022-2023-12-1-14-22 (in Russian)
18. Vachev A.N., Dmitriev O.V., Kozin I.I., et al. Prosthetics of the ascending part and the aortic arch using the hemiarch technique without circulatory arrest in aneurysm and limited dissection. Cardiology and Cardiovascular Surgery. 2020; 13 (2): 151–156. DOI: https://doi.org/10.17116/kardio202013021151 (in Russian)
19. Trimarchi S., de Beaufort H.W.L., Tolenaar J.L., et al. Acute aortic dissections with entry 1285 tear in the arch: A report from the International Registry of Acute Aortic Dissection. Journal of Thoracic and Cardiovascular Surgery. 2019; 157 (1): 66–73. DOI: https://doi.org/10.1016/j.jtcvs.2018.07.101
20. Henn M.C., Moon M.R. Limited versus extended repair for type A aortic dissection involving the aortic arch. Journal of Cardiac Surgery. 2021; 36 (5): 1737–1739. DOI: https://doi.org/10.1111/jocs.15097
21. Ghoreishi M., Sundt T.M., Cameron D.E., et al. Factors associated with acute stroke after type A aortic dissection repair: An analysis of the Society of Thoracic Surgeons National Adult Cardiac Surgery Database. Journal of Thoracic and Cardiovascular Surgery. 2020; 159 (6): 2143–2154.e3. DOI: https://doi.org/10.1016/j.jtcvs.2019.06.016
22. Fillinger M.F., Greenberg R.K., McKinsey J.F., Chaikof E.L.; Society for Vascular Surgery Ad Hoc Committee on TEVAR Reporting Standards. Reporting standards for thoracic endovascular aortic repair (TEVAR). Journal of Vascular Surgery. 2010; 52 (4): 1022–1033. DOI: https://doi.org/10.1016/j.jvs.2010.07.008
23. Poon S.S., Theologou T., Harrington D., et al. Hemiarch versus total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis. Annals of Cardiothoracic Surgery. 2016; 5 (3): 156–173. DOI: https://doi.org/10.21037/acs.2016.05.06
24. Rice R.D., Sandhu H.K., Leake S.S., et al. Is Total Arch Replacement Associated with Worse Outcomes During Repair of Acute Type A Aortic Dissection? Annals of Thoracic Surgery. 2015; 100 (6): 2159–2165. DOI: https://doi.org/10.1016/j.athoracsur.2015.06.007
25. Barbukhatti K.O., Boldyrev S.Yu., Belash S.A., et al. Kuban register of acute aortic dissections of type A (KUBRAD register). Cardiology and Cardiovascular Surgery. 2014; 7 (6): 38–41. (in Russian)
26. Yan Y., Xu L., Zhang H., et al. Proximal aortic repair versus extensive aortic repair in the treatment of acute type A aortic dissection: A meta-analysis. European Journal of Cardio-Thoracic Surgery. 2016; 49 (5): 1392–1401. DOI: https://doi.org/10.1093/ejcts/ezv351
27. Khubulava G.G., Shikhverdiev N.N., Peleshok A.S., et al. Acute aortic syndrome: predictors of hospital mortal. Russian Journal of Thoracic and Cardiovascular Surgery. 2019; 61 (4): 317–322. DOI: https://doi.org/10.24022/0236-2791-2019-61-4-317-322 (in Russian)
28. Yang B., Norton E.L., Hobbs R., et al. Short- and long-term outcomes of aortic root repair and replacement in patients undergoing acute type A aortic dissection repair: twenty-year experience. Journal of Thoracic and Cardiovascular Surgery. 2019; 157 (6): 2125–2136. DOI: https://doi.org/10.1016/j.jtcvs.2018.09.129
29. Rylski B., Beyersdorf F., Kari F.A., et al. Acute type A aortic dissection extending beyond ascending aorta: Limited or extensive distal repair. Journal of Thoracic and Cardiovascular Surgery. 2014; 148 (3): 949–954. DOI: https://doi.org/10.1016/j.jtcvs.2014.05.051
30. Belov Iu.V., Charchian É.R., Stepanenko A.B., et al. Surgical treatment of DeBakey type 1 aortic dissection. Pirogov Russian Journal of Surgery. 2018; 7: 8–17. DOI: https://doi.org/10.17116/hirurgia201878 (in Russian)
31. Larsen M., Trimarchi S., Patel H.J., et al. Extended versus limited arch replacement in acute Type A aortic dissection. European Journal of Cardio-Thoracic Surgery. 2017; 52 (6): 1104–1110. DOI: https://doi.org/10.1093/ejcts/ezx214
32. Mironenko V.A., Mamilov M.-B.T., Garmanov S.V. Evolution of surgical treatment of acute aortic dissection type A. Thoracic and cardiovascular surgery. 2021; 63 (2): 99–109. DOI: https://doi.org/10.24022/0236-2791-2021-63-2-99-109 (in Russian)
33. Charchyan E., Abugov S., Khachatryan Z., et al. Elephant Trunk and Hybrid procedures in DeBakey type I dissection: choice of best treatment technique. The Houston Aortic Symposium. Frontiers in Cardiovascular Diseases. The Tenth in the Series. 2017.
34. Omura A., Miyahara S., Yamanaka K., et al. Early and late outcomes of repaired acute DeBakey type I aortic dissection after graft replacement. Journal of Thoracic and Cardiovascular Surgery. 2016; 151 (2): 341–348. DOI: https://doi.org/10.1016/j.jtcvs.2015.03.068
35. Desai N.D., Hoedt A., Wang G., et al. Simplifying aortic arch surgery: open zone 2 arch with single branched thoracic endovascular aortic repair completion. Annals of Cardiothoracic Surgery. 2018; 7 (3): 351–356. DOI: https://doi.org/10.21037/acs.2018.05.08
36. Gottardi R, Voetsch A, Krombholz-Reindl P, Winkler A, Steindl J, Dinges C, Kirnbauer M, Neuner M, Berger T, Seitelberger R. Comparison of the conventional frozen elephant trunk implantation technique with a modified implantation technique in zone 1. European Journal of Cardio-Thoracic Surgery. 2020; 57 (4): 669–675. https://doi.org/10.1093/ejcts/ezz234
37. Panfilov D.S., Kozlov B.N., Pryakhin A.S., Kopeva K.V. Frozen elephant trunk technique with different proximal landing zone for aortic dissection. Interactive Cardiovascular and Thoracic Surgery. 2021; 33 (2): 286–292. DOI: https://doi.org/10.1093/icvts/ivab086
38. Rosseykin E.V., Evdokimov M.E., Bazylev V.V., et al. Change of paradigm in the aortic arch reconstruction – “warm head – cool body”. Patologiya Krovoobrashcheniya i Kardiokhirurgiya. 2016; 20 (4): 26–33. https://doi.org/10.21688/1681-3472-2016-4-26-33 (in Russian)
39. Czerny M., Schmidli J., Adler S., et al.; EACTS/ESVS scientific document group. Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS). European Journal of Cardio-Thoracic Surgery. 2019; 55 (1): 133–162. DOI: https://doi.org/10.1093/ejcts/ezy313
40. Redkoborodyi A.V., Selyaev V.S., Rubtsov H.B., et al. Features of surgical treatment of acute aortic dissection of type A in a multidisciplinary hospital: methodological recommendations. M.: GBUZ “Research Institute of SP named after N.V. Sklifosovsky DZM”. 2023; 39 p (in Russian)
41. Muslimov R.S., Popova I.E., Khamidova L.T., et al. Computed tomographic criteria for evaluating true and false lumens in aortic dissection. Russian Sklifosovsky Journal of Emergency Medical Care. 2022; 11 (3): 394–401. DOI: https://doi.org/10.23934/2223-9022-2022-11-3-394-401 (in Russian)
42. Chernyavsky A.M., Lyashenko M.M., Syrota D.A., et al. Hybrid technology in the surgical treatment of proximal aortic dissection. Russian Journal of Cardiology. 2018; 23 (11): 8–13. DOI: https://doi.org/10.15829/1560-4071-2018-11-8-13 (in Russian)
43. Preventza O., Olive J.K., Liao J.L., et al. Acute type I aortic dissection with or without antegrade stent delivery: Mid-term outcomes. Journal of Thoracic and Cardiovascular Surgery. 2019; 158 (5): 1273–1281. DOI: https://doi.org10.1016/j.jtcvs.2018.11.145
44. Leontyev S., Tsagakis K., Pacini D., et al. Impact of clinical factors and surgical techniques on early outcome of patients treated with frozen elephant trunk technique by using EVITA open stent-graft: Results of a multicentre study. European Journal of Cardio-Thoracic Surgery. 2016; 49 (2): 660–666. DOI: https://doi.org/10.1093/ejcts/ezv150
45. Leone A., Beckmann E., Aandreas M., et al. Total aortic arch replacement with frozen elephant trunk technique: Results from two European institutes. Journal of Thoracic and Cardiovascular Surgery. 2020; 159 (4): 1201–1211. DOI: https://doi.org/10.1016/j.jtcvs.2019.03.121
46. Sokolov V. V., Redkoborody A.V., Rubtsov N.V., et al. Modern approaches to emergency surgical interventions on the aortic arch in acute type A dissection. Cardiology: news, opinions, training. 2017; 12 (1): 77. (in Russian)
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