"Sleeve" Sinus of Valsalva Repair in Patients with Acute Type A Aortic Dissection

Authors

  • Laichun Song, MD Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, P.R. China, Affiliated Wuhan University of Science and Technology, Wuhan, P.R. China
  • Yang Gao, MD Department of Anesthesiology, Asia Heart Hospital, Wuhan, P.R. China
  • Ming Xu, MD Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, P.R. China, Affiliated Wuhan University of Science and Technology, Wuhan, P.R. China
  • Bo Wang, MD Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, P.R. China, Affiliated Wuhan University of Science and Technology, Wuhan, P.R. China
  • Xiaoyong Li, MD Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, P.R. China, Affiliated Wuhan University of Science and Technology, Wuhan, P.R. China
  • Xiao Wang, MD Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, P.R. China, Affiliated Wuhan University of Science and Technology, Wuhan, P.R. China

DOI:

https://doi.org/10.1532/hsf.3629

Keywords:

Acute type A aortic dissection, Aortic Root Reconstruction, Aortic Valve

Abstract

Purpose: The optimal surgical strategy of aortic root in acute type A aortic dissection (ATAAD) is controversial. The aim of this study was to evaluate the feasibility and safety of “Sleeve” Sinus of Valsalva repair for AAD limited to the non-coronary sinus or partial left and right coronary sinus without involvement coronary artery ostia.

Methods: From September 2016 to March 2019, 20 patients with AAD involving non-coronary sinus or partial left and right coronary sinus Valsalva underwent “Sleeve” Sinus of Valsalva repair. A tailored Dacron patch was inserted into the dissected layers and two Dacron strips were placed inside and outside of the aorta, and the new five-layers root was sutured with 3/0 prolene continuous stitches. The artificial vessel was reversed about 1cm and anastomosed with the reconstructed root. Then, the reversed artificial vessel was pulled and anastomosed with the Dacron strip of the new proximal aorta.

Results: There was no early death in hospital and one death occurred during the 30-day postoperative period. Re-thoracotomy due to bleeding was necessary in only one patient and no bleeding was related to the proximal anastomosis. The postoperative drainage was 390.5 ± 229.3 mL. During follow up, the echocardiography showed the normal sinus of Valsalva and aortic valvular function. Computed tomography angiography showed normal aortic root without endovascular leak or dissection around the sinus of Valsalva. All patients were free from reoperation.

Conclusions: “Sleeve” Sinus of Valsalva repair with Dacron patch for aortic dissection limited to the non-coronary sinus or partial left and right coronary sinus without involvement coronary artery ostia was technically feasible and safe.

References

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Published

2021-05-11

How to Cite

Song, L., Gao, Y. ., Xu, M. ., Wang, B. ., Li, X. ., & Wang, X. (2021). "Sleeve" Sinus of Valsalva Repair in Patients with Acute Type A Aortic Dissection. The Heart Surgery Forum, 24(3), E418-E421. https://doi.org/10.1532/hsf.3629

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