Clinical Outcomes of Cabrol Procedure for the Treatment of Stanford Type A Aortic Dissection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIXin ,  FANRui-xin , ZHANGHong-yu , YUChang-jiang , FANGXiao-ping , MAShao-hong

Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, P. R. China;

Corresponding author：

FANRui-xin, Email: fanruixin@163.com

Keywords：

Aortic dissection; Cabrol procedure; Surgical treatment

DOI：

10.7507/1007-4848.20150057

Video：

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Objective To analyze the clinical outcomes of Cabrol procedure for the treatment of Stanford type A aortic dissection. Methods Clinical data of 37 patients with Stanford type A aortic dissection underwent Cabrol procedure at the Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute from January 2009 to April 2014 were retrospectively analyzed. There were 34 males and 3 females aged at 21 to 66 years. The average interval time from onset to getting operation was 15.2±28.5 days. All patients received Cabrol procedure was performed for aortic root. According to different aortic arch conditions, hemiarch replacement or total arch replacement combined endovascular aortic repair with stent were performed. Results All the operations were successfully performed including isolated Cabrol procedure in 4 patients, right hemiarch replacement in 10 patients and total arch replacement combined endovascular aortic repair with stent in 23 patients. One patient (2.7%) underwent reexploration for postoperative bleeding. Postoperative mortality was 10.8% (4/37). Follow-up duration was 1-24 months, 2 patients died during follow-up. Conclusion Cabrol procedure has satisfactory clinical outcomes for Stanford type A AD and long-term patency of aortic without coronary oppression.

Citation： LIXin, FANRui-xin, ZHANGHong-yu, YUChang-jiang, FANGXiao-ping, MAShao-hong. Clinical Outcomes of Cabrol Procedure for the Treatment of Stanford Type A Aortic Dissection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 198-201. doi: 10.7507/1007-4848.20150057 Copy

1.	Hagan PG, Nienaber CA, Isselbacher EM, et al.The international registry of acute aortic dissection (irad):new insights into an old disease.JAMA, 2000, 283(7):897-903.
2.	Sun L, Qi R, Zhu J, et al.Repair of acute type a dissection:our experiences and results.Ann Thorac Surg, 2011, 91(4):1147-1152.
3.	Howard DP, Sideso E, Handa A, et al.Incidence, risk factors, outcome and projected future burden of acute aortic dissection.Ann Cardiothorac Surg, 2014, 3(3):278-284.
4.	Schoenhoff FS, Jungi S, Czerny M, et al.Acute aortic dissection determines the fate of initially untreated aortic segments in marfan syndrome.Circulation, 2013, 127(15):1569-1575.
5.	Howard DP, Banerjee A, Fairhead JF, et al.Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control:10-year results from the oxford vascular study.Circulation, 2013, 127(20):2031-2037.
6.	孙立忠.主动脉夹层诊断和治疗相关问题探讨.中华外科杂志, 2005, 43(18):1169-1170.
7.	Westaby S, Saito S, Katsumata T.Acute type a dissection:conservative methods provide consistently low mortality.Ann Thorac Surg, 2002, 73(3):707-713.
8.	Sun LZ, Qi RD, Chang Q, et al.Surgery for acute type a dissection using total arch replacement combined with stented elephant trunk implantation:experience with 107 patients.J Thorac Cardiovasc Surg, 2009, 138(6):1358-1362.
9.	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.
10.	Kazui T, Yamashita K, Washiyama N, et al.Aortic arch replacement using selective cerebral perfusion.Ann Thorac Surg, 2007, 83(2):S796-S798.
11.	Mizuno T, Toyama M, Tabuchi N, et al.Stented elephant trunk procedure combined with ascending aorta and arch replacement for acute type A aortic dissection.Eur J Cardiothorac Surg, 2002, 22(4):504-509.
12.	Bonser RS, Ranasinghe AM, Loubani M, et al.Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection.J Am Coll Cardiol, 2011, 58(24):2455-2474.
13.	韩宏光, 李鉴峰, 张南滨, 等.升主动脉瘤合并主动脉瓣关闭不全外科手术后早期处理.中国胸心血管外科临床杂志, 2005, 12(4):283-284.
14.	Cabrol C, Pavie A, Mesnildrey P, et al.Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries.J Thorac Cardiovasc Surg, 1986, 91(1):17-25.
15.	Gott VL, Greene PS, Alejo DE, et al.Replacement of the aortic root in patients with marfan's syndrome.N Engl J Med, 1999, 340(17):1307-1313.
16.	孙立忠, 刘志刚, 常谦, 等.主动脉弓替换加支架"象鼻"手术治疗Stanford A型主动脉夹层.中华外科杂志, 2004, 42(13):812-816.
17.	Kawahito K, Adachi H, Murata S, et al.Coronary malperfusion due to type A aortic dissection:mechanism and surgical management.Ann Thorac Surg, 2003, 76(5):1471-1476.
18.	Motallebzadeh R, Batas D, Valencia O, et al.The role of coronary angiography in acute type A aortic dissection.Eur J Cardiothorac Surg, 2004, 25(2):231-235.
19.	Cabrol C, Gandjbakhc I, Pavie A.Surgical treatment of ascending aortic pathology.J Card Surg, 1988, 3(3):167-180.
20.	王敏生, 王春生, 丁文军, 等.114例升主动脉瘤的外科治疗.中国胸心血管外科临床杂志, 2005, 12(1):1-3.

1. Hagan PG, Nienaber CA, Isselbacher EM, et al.The international registry of acute aortic dissection (irad):new insights into an old disease.JAMA, 2000, 283(7):897-903.
2. Sun L, Qi R, Zhu J, et al.Repair of acute type a dissection:our experiences and results.Ann Thorac Surg, 2011, 91(4):1147-1152.
3. Howard DP, Sideso E, Handa A, et al.Incidence, risk factors, outcome and projected future burden of acute aortic dissection.Ann Cardiothorac Surg, 2014, 3(3):278-284.
4. Schoenhoff FS, Jungi S, Czerny M, et al.Acute aortic dissection determines the fate of initially untreated aortic segments in marfan syndrome.Circulation, 2013, 127(15):1569-1575.
5. Howard DP, Banerjee A, Fairhead JF, et al.Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control:10-year results from the oxford vascular study.Circulation, 2013, 127(20):2031-2037.
6. 孙立忠.主动脉夹层诊断和治疗相关问题探讨.中华外科杂志, 2005, 43(18):1169-1170.
7. Westaby S, Saito S, Katsumata T.Acute type a dissection:conservative methods provide consistently low mortality.Ann Thorac Surg, 2002, 73(3):707-713.
8. Sun LZ, Qi RD, Chang Q, et al.Surgery for acute type a dissection using total arch replacement combined with stented elephant trunk implantation:experience with 107 patients.J Thorac Cardiovasc Surg, 2009, 138(6):1358-1362.
9. 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.
10. Kazui T, Yamashita K, Washiyama N, et al.Aortic arch replacement using selective cerebral perfusion.Ann Thorac Surg, 2007, 83(2):S796-S798.
11. Mizuno T, Toyama M, Tabuchi N, et al.Stented elephant trunk procedure combined with ascending aorta and arch replacement for acute type A aortic dissection.Eur J Cardiothorac Surg, 2002, 22(4):504-509.
12. Bonser RS, Ranasinghe AM, Loubani M, et al.Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection.J Am Coll Cardiol, 2011, 58(24):2455-2474.
13. 韩宏光, 李鉴峰, 张南滨, 等.升主动脉瘤合并主动脉瓣关闭不全外科手术后早期处理.中国胸心血管外科临床杂志, 2005, 12(4):283-284.
14. Cabrol C, Pavie A, Mesnildrey P, et al.Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries.J Thorac Cardiovasc Surg, 1986, 91(1):17-25.
15. Gott VL, Greene PS, Alejo DE, et al.Replacement of the aortic root in patients with marfan's syndrome.N Engl J Med, 1999, 340(17):1307-1313.
16. 孙立忠, 刘志刚, 常谦, 等.主动脉弓替换加支架"象鼻"手术治疗Stanford A型主动脉夹层.中华外科杂志, 2004, 42(13):812-816.
17. Kawahito K, Adachi H, Murata S, et al.Coronary malperfusion due to type A aortic dissection:mechanism and surgical management.Ann Thorac Surg, 2003, 76(5):1471-1476.
18. Motallebzadeh R, Batas D, Valencia O, et al.The role of coronary angiography in acute type A aortic dissection.Eur J Cardiothorac Surg, 2004, 25(2):231-235.
19. Cabrol C, Gandjbakhc I, Pavie A.Surgical treatment of ascending aortic pathology.J Card Surg, 1988, 3(3):167-180.
20. 王敏生, 王春生, 丁文军, 等.114例升主动脉瘤的外科治疗.中国胸心血管外科临床杂志, 2005, 12(1):1-3.

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