Midterm cerebral outcomes of Stanford type A aortic dissection in patients who underwent novel triple-branched stent graft implantation combined with intraoperative monitoring of regional cerebral oxygen saturation.

Lin, Yong; Chen, Mei‐Fang; Chen, Liang‐Wan; Wang, Jie‐Bo; Zhang, Hui; Li, Ruo‐Meng; Chen, Mei-Fang; Chen, Liang-Wan; Wang, Jie-Bo; Li, Ruo-Meng

<bold>Objective: </bold>The aim of this study was to evaluate the cerebral outcomes of patients underwent novel triple-branched stent graft implantation combined with the intraoperative monitoring of regional cerebral oxygen saturation.<bold>Methods: </bold>One hundred thirty-seven consecutive patients who underwent the surgery of triple-branched stent graft implantation in our department were enrolled in this retrospective case-control study. The patients in group A received brain protection based on the intraoperative monitoring of regional cerebral oxygen saturation and the patients in group B received conventional brain protection. The general clinical data, the types of corrective surgeries, the intraoperative situations, the postoperative complications, and the midterm outcomes of the patients were analyzed.<bold>Results: </bold>The incidence of postoperative cerebral dysfunction in the patients of group A was significantly lower than that in the patients in group B (3.2% vs 14.9%, P = .020). We found significant differences in the incubation times (30.3 ± 22.1 vs 42.3 ± 27.9 hours, P = .014), the lengths of intensive care unit stay (58.0 ± 54.3 vs 79.7 ± 55.5 hours, P = .004), and the hospital stays (19.3 ± 6.7 vs 24.9 ± 17.3 days, P = .045). A descending trend in the mortality rates was observed between the patients in the two groups based on the 20 months of observation; however, this trend was not statistically significant (1.6% vs 6.8%, P = .218).<bold>Conclusions: </bold>The novel triple-branched stent graft implantation procedure combined with intraoperative monitoring of the regional cerebral oxygen saturation was an effective treatment for Stanford type A aortic dissection, with a relatively low incidence of postoperative cerebral dysfunction.

DISSOLVED oxygen in water; AORTIC dissection; INTRAOPERATIVE monitoring; INTENSIVE care units; SURGICAL stents; SURGICAL complications

Journal of Cardiac Surgery, 2019, Vol 34, Issue 9, p774

0886-0440

Academic Journal

10.1111/jocs.14130