The effect of Cabrol in treatment of Stanford type A aortic dissection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 YANG Jianguo , ZHAO Jinping , XU Ming , ZHANG li

Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430070, P.R.China;

Corresponding?author：

YANG Jianguo, Email: 979638260@qq.com

Keywords：

Cabrol’s operation; Stanford type A aortic dissection; effect evaluation

DOI：

10.7507/1007-4848.201810007

Video：

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Objective To discuss the effect of Cabrol in treatment of Stanford type A aortic dissection.Methods The clinical data of patients whom were diagnosed with type A aortic dissection of Stanford in our hospital from January 2013 to January 2018 were retrospectively analyzed. All of 40 patients underwent Cabrol surgical procedure. There were 31 males and 9 females aged 26–75 (48.8±3.3) years. The surgical treatment effect of the patients was evaluated, mainly including the aortic index, the changes in cardiac function before and after operation, and the postoperative follow-up.Results All the 40 patients completed the operation successfully. The diameter of ascending aorta and aortic sinus in postoperative patients were smaller than those before operation (P<0.05). Postoperative left ventricular ejection fraction and cardiac output increased, central venous pressure and left ventricular end-diastolic dimension decreased, and cardiac function indexes were significantly different from those before the operation (P<0.05). Seven patients suffered complications in postoperative follow-up including one stenting leakage, three neurological diseases and three acute renal failure. Two patients died postoperatively.Conclusion Cabrol’s operation is effective in the treatment of Stanford type A aortic dissection, which can significantly improve the cardiac function of patients, simplify the anastomosis of coronary artery ostia and decrease amount of bleeding.

Citation： YANG Jianguo, ZHAO Jinping, XU Ming, ZHANG li. The effect of Cabrol in treatment of Stanford type A aortic dissection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(7): 670-673. doi: 10.7507/1007-4848.201810007 Copy

1.	Patel HJ, Deeb GM. Ascending and arch aorta: pathology, natural history, and treatment. Circulation, 2008, 118(2): 188-195.
2.	Ohlmann P, Faure A, Morel O, et al. Diagnostic and prognostic value of circulating D-Dimers in patients with acute aortic dissection. Crit Care Med, 2006, 34(5): 1358-1364.
3.	Golledge J, Eagle KA. Acute aortic dissection. Lancet, 2008, 372(9632): 55-66.
4.	Isselbacher EM, Chief editor. Epidemiology of thoracic aortic aneurysms, aortic dissection, intramular hematnma, and penetrating atherosclerotic ulcers. Baliga RR, Nienaber CA, lsselbacher EM, et al, ed. Aortic Dissection and Related Syndromes. New York: Springer Science, 2007. 3-15.
5.	Luo F, Zhou XL, Li JJ, et al. Inflammatory response is associated with aortic dissection. Ageing Res Rev, 2009, 8: 31-35.
6.	Sun L, Qi R, Chang Q, et al. Surgery for Marfan patients with acute type a dissection using a stented elephant trunk procedure. Ann Thorac Surg, 2008, 86(6): 1821-1825.
7.	李濱, 孫立忠, 常謙, 等. 全弓替換加支架象鼻技術治療復雜 Standford B 型主動脈夾層的臨床觀察. 中華醫學雜志, 2010, 90(5): 323-326.
8.	Sun L, Zhao X, Chang Q, et al. Repair of chronic type B dissection with aortic arch involvement using a stented elephant trunk procedure. Ann Thorac Surg, 2010, 90(1): 95-100.
9.	Zhao HP, Zhu JM, Ma WG, et al. Total arch replacement with stented elephant trunk technique for acute type B aortic dissection involving the aortic arch. Ann Thorac Surg, 2012, 93(5): 1517-1522.
10.	Sun L, Qi R, Zhu J, et al. Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch? Circulation, 2011, 123(9): 971-978.
11.	龐鋒, 陳興澎. 支架象鼻開窗簡化手術在治療急性 Stanford A 型主動脈夾層中的臨床分析. 中國心血管病研究, 2017, 15(11): 999-1001.
12.	孫祥飛, 孫文宇, 霍玉峰, 等. 改良 Y 型人工血管技術治療急性 Stanford A 型主動脈夾層的短期療效觀察. 世界最新醫學信息文摘, 2018, 18(16): 77-178, 180.
13.	吳怡錦, 熊衛萍, 曾嶸, 等. 孫氏手術治療急、慢性 Stanford A 型主動脈夾層療效的病例對照研究. 中國胸心血管外科臨床雜志, 2018, 25(5): 401-405.
14.	程鳳, 陳慶良, 姜楠, 等. 孫氏手術與三分支主動脈弓覆膜支架治療 Stanford A 型主動脈夾層的效果比較. 天津醫藥, 2016, 44(8): 951-954.
15.	熊師, 公兵, 田聰聰, 等. 三分支支架治療急性 Stanford A 型主動脈夾層療效的臨床研究. 中國循環雜志, 2017, 32(s1): 147.
16.	潘俊, 宣煜龍, 陳小芳, 等. 孫氏手術治療急性 Stanford A 型主動脈夾層. 中華胸心血管外科雜志, 2015, 31(6): 333-335.
17.	吳玉輝, 江蕊, 江磊, 等. 88 例 Stanford A 型主動脈夾層外科治療效果. 臨床軍醫雜志, 2017, 24(11): 1149-1152.
18.	李欣, 范瑞新, 張洪宇, 等. Cabrol 手術應用于 Stanford A 型主動脈夾層的療效分析. 中國胸心血管外科臨床雜志, 2015, 22(3): 198-201.
19.	Ghazy T, Eraqi M, Mahlmann A, et al. Quality of life after surgery for Stanford type A aortic dissection: influences of different operative strategies. Heart Surg Forum, 2017, 20(3): E102-E106.
20.	Cheng Y, Jin M, Dong X, et al. Mechanism and early intervention research on ALI during emergence surgery of Stanford type-A AAD: Study protocol for a prospective, double-blind, clinical trial. Medicine (Baltimore), 2016, 95(42): e5164.

1. Patel HJ, Deeb GM. Ascending and arch aorta: pathology, natural history, and treatment. Circulation, 2008, 118(2): 188-195.
2. Ohlmann P, Faure A, Morel O, et al. Diagnostic and prognostic value of circulating D-Dimers in patients with acute aortic dissection. Crit Care Med, 2006, 34(5): 1358-1364.
3. Golledge J, Eagle KA. Acute aortic dissection. Lancet, 2008, 372(9632): 55-66.
4. Isselbacher EM, Chief editor. Epidemiology of thoracic aortic aneurysms, aortic dissection, intramular hematnma, and penetrating atherosclerotic ulcers. Baliga RR, Nienaber CA, lsselbacher EM, et al, ed. Aortic Dissection and Related Syndromes. New York: Springer Science, 2007. 3-15.
5. Luo F, Zhou XL, Li JJ, et al. Inflammatory response is associated with aortic dissection. Ageing Res Rev, 2009, 8: 31-35.
6. Sun L, Qi R, Chang Q, et al. Surgery for Marfan patients with acute type a dissection using a stented elephant trunk procedure. Ann Thorac Surg, 2008, 86(6): 1821-1825.
7. 李濱, 孫立忠, 常謙, 等. 全弓替換加支架象鼻技術治療復雜 Standford B 型主動脈夾層的臨床觀察. 中華醫學雜志, 2010, 90(5): 323-326.
8. Sun L, Zhao X, Chang Q, et al. Repair of chronic type B dissection with aortic arch involvement using a stented elephant trunk procedure. Ann Thorac Surg, 2010, 90(1): 95-100.
9. Zhao HP, Zhu JM, Ma WG, et al. Total arch replacement with stented elephant trunk technique for acute type B aortic dissection involving the aortic arch. Ann Thorac Surg, 2012, 93(5): 1517-1522.
10. Sun L, Qi R, Zhu J, et al. Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch? Circulation, 2011, 123(9): 971-978.
11. 龐鋒, 陳興澎. 支架象鼻開窗簡化手術在治療急性 Stanford A 型主動脈夾層中的臨床分析. 中國心血管病研究, 2017, 15(11): 999-1001.
12. 孫祥飛, 孫文宇, 霍玉峰, 等. 改良 Y 型人工血管技術治療急性 Stanford A 型主動脈夾層的短期療效觀察. 世界最新醫學信息文摘, 2018, 18(16): 77-178, 180.
13. 吳怡錦, 熊衛萍, 曾嶸, 等. 孫氏手術治療急、慢性 Stanford A 型主動脈夾層療效的病例對照研究. 中國胸心血管外科臨床雜志, 2018, 25(5): 401-405.
14. 程鳳, 陳慶良, 姜楠, 等. 孫氏手術與三分支主動脈弓覆膜支架治療 Stanford A 型主動脈夾層的效果比較. 天津醫藥, 2016, 44(8): 951-954.
15. 熊師, 公兵, 田聰聰, 等. 三分支支架治療急性 Stanford A 型主動脈夾層療效的臨床研究. 中國循環雜志, 2017, 32(s1): 147.
16. 潘俊, 宣煜龍, 陳小芳, 等. 孫氏手術治療急性 Stanford A 型主動脈夾層. 中華胸心血管外科雜志, 2015, 31(6): 333-335.
17. 吳玉輝, 江蕊, 江磊, 等. 88 例 Stanford A 型主動脈夾層外科治療效果. 臨床軍醫雜志, 2017, 24(11): 1149-1152.
18. 李欣, 范瑞新, 張洪宇, 等. Cabrol 手術應用于 Stanford A 型主動脈夾層的療效分析. 中國胸心血管外科臨床雜志, 2015, 22(3): 198-201.
19. Ghazy T, Eraqi M, Mahlmann A, et al. Quality of life after surgery for Stanford type A aortic dissection: influences of different operative strategies. Heart Surg Forum, 2017, 20(3): E102-E106.
20. Cheng Y, Jin M, Dong X, et al. Mechanism and early intervention research on ALI during emergence surgery of Stanford type-A AAD: Study protocol for a prospective, double-blind, clinical trial. Medicine (Baltimore), 2016, 95(42): e5164.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The effect of Cabrol in treatment of Stanford type A aortic dissection

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