NCT05346497

Surgical Management of the Aortic Root and Long-term Outcomes For Acute Type A Aortic Dissection

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 1,600 (actual)
• Sponsor: Shanghai Zhongshan Hospital · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The investigators focus on the patients who underwent aortic root surgery for acute type A aortic dissection between 2005.01-2021.11. The patients are divided into 3 groups according to the different aortic root surgical methods(Bentall，David and root reconstruction). Clinical data including age, gender, comorbidities, surgical informations and perioperative informations will be collected. All patients will receive follow-ups in hospital or by telephone. All the informations will be analyzed by SPSS to show the difference of both perioperative and long-term results among different surgical strategies.

Detailed description

Acute type A aortic dissection (ATAAD) is a rare but life threatening situation requiring immediate intervention. Regarding emergency operation for ATAAD, an important principle is to reconstruct the afflicted aorta to prevent fatal rupture. For aortic root dissection, the Bentall procedure has been the standard operation and has been proven simple and effective. However, the requirement for lifelong anticoagulation therapy is associated with increased risk of thromboembolic and bleeding complications. Valve sparing aortic root reimplantation (David reimplantation), which has been proven effective in root aneurysm with satisfactory safety and long-term outcomes, is an appealing alternative to preserve native aortic valve, especially for younger patients with intact valve function. Aortic root reconstruction without valve surgery is also a well-used strategy for aortic root dissection, but the long-term outcome is still controversial. The investigators focus on the patients who underwent aortic root surgery for acute type A aortic dissection between 2005.01-2021.11. The patients are divided into 3 groups according to the different aortic root surgical methods(Bentall，David and root reconstruction). Clinical data including age, gender, comorbidities, surgical informations and perioperative informations will be collected. All patients will receive follow-ups in hospital or by telephone. All the informations will be analyzed by SPSS to show the difference of both perioperative and long-term results among different surgical strategies.

Conditions

• Type A Aortic Dissection

Interventions

Type	Name	Description
PROCEDURE	Bentall	Bentall procedure: include replacement of both aortic valve and root
PROCEDURE	David	David procedure: include replacement of aortic root and aortic valvuloplasty
PROCEDURE	ARR	Aortic root reconstruction: reconstruction instead of replacement of aortic root, without surgery of the valve. include sandwich procedure, adventitia invertion procedure, etc.

Timeline

• Start date: 2005-01-01
• Primary completion: 2021-11-01
• Completion: 2021-11-01
• First posted: 2022-04-26
• Last updated: 2022-04-26