Research progress on end-to-end anastomosis in surgical treatment of acute Stanford A aortic dissection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WEI Ke ,  GUO Hongwei

Department of Cardiovascular Surgery, Fuwai Hospital, Beijing Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China;

Corresponding author：

GUO Hongwei, Email: ghwdr@sina.com

Keywords：

Aortic dissection; end-to-end anastomosis; complications; long-term survival

DOI：

10.7507/1007-4848.201801008

Video：

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The surgical treatment of acute aortic dissection is difficult, and the mortality is associated with anastomosis site complications. Therefore, it is essential to make sure the end-to-end anastomosis safe and avoid bleeding. The methods of anastomosis include: direct anastomosis, adventitial inversion technique and sandwich technique. The latter two methods are both effective in hemostasis and reducing the postoperative complications. According to the recent literatures, the adventitial inversion technique may facilitate thrombotic closure of the false lumen in acute type A aortic dissection management and increase the long-term survival of the patients. This review introduces 2 modified methods of anastomosis as well, and summarizes clinical outcomes of different end-to-end anastomotic methods for surgical treatment of acute Stanford type A aortic dissection, in order to recommend the most proper method of end-to-end anastomosis.

Citation： WEI Ke, GUO Hongwei. Research progress on end-to-end anastomosis in surgical treatment of acute Stanford A aortic dissection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(12): 1085-1090. doi: 10.7507/1007-4848.201801008 Copy

1.	Chiappini B, Schepens M, Tan E, et al. Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients. Eur Heart J, 2005, 26(2): 180-186.
2.	Moon MR. Approach to the treatment of aortic dissection. Surg Clin North Am, 2009, 89(4): 869-893.
3.	Braverman AC. Aortic dissection: prompt diagnosis and emergency treatment are critical. Br J Hosp Med (Lond), 2017, 78(6): 320-326.
4.	Redfern E, Callaway M, Zakkar M, et al. Improving outcomes in acute aortic dissection. Br J Hosp Med (Lond), 2017, 78(6): 320-326.
5.	尚蔚, 刘楠, 闫晓蕾, 等. A型主动脉夹层手术后早期并发症分析. 心肺血管病杂志, 2011, 30(3): 183-186.
6.	康凯, 张宇南, 谢宝栋, 等. 22例Stanford A型主动脉夹层手术止血技巧体会. 心肺血管病杂志, 2011, 30(6): 521-523.
7.	Svensson LG, Crawford ES, Hess KR, et al. Dissection of the aorta and dissecting aortic aneurysms. Improving early and long-term surgical results. Circulation, 1990, 82(5 Suppl): I24-I38.
8.	Fattori R, Bacchi-Reggiani L, Bertaccini P, et al. Evolution of aortic dissection after surgical repair. Am J Cardiol, 2000, 86(8): 868-872.
9.	Bernard Y, Zimmermann H, Chocron S, et al. False lumen patency as a predictor of late outcome in aortic dissection. Am J Cardiol, 2001, 87(12): 1378-1382.
10.	Moore NR, Parry AJ, Trottman-Dickenson B, et al. Fate of the native aorta after repair of acute type A dissection: a magnetic resonance imaging study. Heart, 1996, 75(1): 62-66.
11.	Heijmen RH, Gründeman PF, Borst C. Intima-adventitia apposition in end-to-side arterial anastomosis: an experimental study in the pig. Ann Thorac Surg, 1998, 65(3): 705-711.
12.	Sabik JF, Lytle BW, Blackstone EH, et al. Long-term effectiveness of operations for ascending aortic dissections. J Thorac Cardiovasc Surg, 2000, 119(5): 946-962.
13.	Driever R, Botsios S, Schmitz E, et al. Long-term effectiveness of operative procedures for Stanford type A aortic dissections. Cardiovasc Surg, 2003, 11(4): 265-272.
14.	Immer FF, Hagen U, Berdat PA, et al. Risk factors for secondary dilatation of the aorta after acute type A aortic dissection. Eur J Cardiothorac Surg, 2005, 27(4): 654-657.
15.	Olsson C, Eriksson N, Ståhle E, et al. Surgical and long-term mortality in 2634 consecutive patients operated on the proximal thoracic aorta. Eur J Cardiothorac Surg, 2007, 31(6): 963-969.
16.	Rylski B, Siepe M, Blanke P, et al. Adventitial inversion with graft telescopic insertion for distal anastomosis in acute type a aortic dissection. Ann Thorac Cardiovasc Surg, 2012, 18(3): 278-280.
17.	Ohata T, Miyamoto Y, Mitsuno M, et al. Modified sandwich technique for acute aortic dissection. Asian Cardiovasc Thorac Ann, 2007, 15(3): 261-263.
18.	郭应强, 张尔永, 蒙炜, 等. 急性A型主动脉夹层手术主动脉断端加固方法的改进. 中国胸心血管外科临床杂志, 2009, 16(5): 389-391.
19.	秦卫, 黄福华, 陈鑫, 等. 不同主动脉断端加固方法在急性Stanford A型主动脉夹层手术中的应用. 中国胸心血管外科临床杂志, 2014, 21(3): 356-360.
20.	Floten HS, Ravichandran PS, Furnary AP, et al. Adventitial inversion technique in repair of aortic dissection. Ann Thorac Surg, 1995, 59(3): 771-772.
21.	García-Rinaldi R, Carballido J, Mojica J, et al. Surgical treatment of aortic dissections: initial experience with the adventitial inversion technique. Ann Thorac Surg, 1998, 65(5): 1255-1259.
22.	Tanaka K, Morioka K, Li W, et al. Adventitial inversion technique without the aid of biologic glue or Teflon buttress for acute type A aortic dissection. Eur J Cardiothorac Surg, 2005, 28(6): 864-869.
23.	Kim SW, Sung K, Lee YT, et al. Aortic false lumen patency following the adventitial inversion technique for acute DeBakey type Ⅰ aortic dissection. J Card Surg, 2010, 25(5): 548-553.
24.	Oda T, Minatoya K, Sasaki H, et al. Adventitial inversion technique for type A aortic dissection distal anastomosis. J Thorac Cardiovasc Surg, 2016, 151(5): 1340-1345.
25.	Tanaka K, Yamamoto K, Hiraiwa T, et al. Early and mid-term outcomes of surgical treatment with conservative approach using adventitial inversion technique for an acute type A aortic dissection. Kyobu Geka, 2016, 69(4): 257-262.
26.	Oda K, Akimoto H, Hata M, et al. Use of cuffed anastomosis in total aortic arch replacement. Ann Thorac Surg, 2003, 76(3): 952-953.
27.	Ogino H. Open repair of distal aortic arch and proximal descending thoracic aortic aneurysm using a stepwise distal anastomosis. Oper Tech Thorac Cardiovasc Surg, 2007, 12(3): 162-166.
28.	汪黎明, 陈鑫, 获野均. 逐步吻合式全弓置换术治疗伴有远端延伸的主动脉弓部瘤. 中华外科杂志, 2008, 46(7): 556-557.
29.	Matsuyama S, Tabata M, Shimokawa T, et al. Outcomes of total arch replacement with stepwise distal anastomosis technique and modified perfusion strategy. J Thorac Cardiovasc Surg, 2012, 143(6): 1377-1381.
30.	Inoue Y, Minatoya K, Itonaga T, et al. Utility of proximal stepwise technique for acute aortic dissection involving the aortic root. Ann Thorac Surg, 2016, 101(5): e183-e185.
31.	Ogino H, Ando M, Sasaki H, et al. Total arch replacement using a stepwise distal anastomosis for arch aneurysms with distal extension. Eur J Cardiothorac Surg, 2006, 29(2): 255-257.
32.	Imoto K. Recent status of gelatin-resorcin-formalin glue for acute type A aortic dissection. Gen Thorac Cardiovasc Surg, 2011, 59(5): 313-314.
33.	Shiono M. Surgery for acute aortic dissection using gelatin-resorcin-formalin glue: perspective from 10 years of follow-up at a single center. J Artif Organs, 2008, 11(1): 19-23.
34.	Fehrenbacher JW, Siderys H. Use of BioGlue in aortic surgery: proper application techniques and results in 92 patients. Heart Surg Forum, 2006, 9(5): E794-E799.
35.	Rylski B, Bavaria JE, Milewski RK, et al. Long-term results of neomedia sinus valsalva repair in 489 patients with type A aortic dissection. Ann Thorac Surg, 2014, 98(2): 582-588.
36.	Hoschtitzky JA, Crawford L, Brack M, et al. Acute coronary syndrome following repair of aortic dissection. Eur J Cardiothorac Surg, 2004, 26(4): 860-862.
37.	von Oppell UO, Karani Z, Brooks A, et al. Dissected aortic sinuses repaired with gelatin-resorcin-formaldehyde (GRF) glue are not stable on follow up. J Heart Valve Dis, 2002, 11(2): 249-257.
38.	Mastroroberto P, Chello M, Onorati F, et al. Embolisation, inflammatory reaction and persistent patent false lumen: is biological glue really effective in repair of type A aortic dissection? Eur J Cardiothorac Surg, 2005, 27(3): 531-532.
39.	Suehiro K, Hata T, Yoshitaka H, et al. Late aortic root redissection following surgical treatment for acute type A aortic dissection using Gelatin-Resorcin-Formalin glue. Jpn J Thorac Cardiovasc Surg, 2002, 50(5): 195-200.
40.	Bingley JA, Gardner MA, Stafford EG, et al. Late complications of tissue glues in aortic surgery. Ann Thorac Surg, 2000, 69(6): 1764-1768.
41.	Kazui T, Washiyama N, Bashar AH, et al. Role of biologic glue repair of proximal aortic dissection in the development of early and midterm redissection of the aortic root. Ann Thorac Surg, 2001, 72(2): 509-514.
42.	Luk A, David TE, Butany J. Complications of Bioglue postsurgery for aortic dissections and aortic valve replacement. J Clin Pathol, 2012, 65(11): 1008-1012.
43.	Weiner J, Widman S, Golek Z, et al. Role of bovine serum albumin-glutaraldehyde glue in the formation of anastomatic pseudoaneurysms. J Card Surg, 2011, 26(1): 76-81.
44.	Alameddine A, Alimov VK, Rousou JA, et al. Aortopulmonary artery disruption following acute type-A aortic dissection repair with the use of BioGlue®. J Card Surg, 2012, 27(3): 371-373.
45.	Rubio Alvarez J, Sierra Quiroga J, Martinez de Alegria A, et al. Pulmonary embolism due to biological glue after repair of type A aortic dissection. Interact Cardiovasc Thorac Surg, 2011, 12(4): 650-651.
46.	Kimura C, Takihara H, Okada S. Coronary embolism probably caused by surgical glue after operation for acute aortic dissection; report of a case. Kyobu Geka, 2016, 69(7): 548-551.
47.	Furukawa H, Masaki H, Tanemoto K. Late limb embolization of biological glue after repair of aortic dissection. Eur J Cardiothorac Surg, 2015, 48(4): 633.
48.	Kobayashi T, Kurazumi H, Sato M, et al. Pseudoaneurysm rupture after acute Type A dissection repair: possible reaction to BioGlue. Interact Cardiovasc Thorac Surg, 2018, 26(2): 331-332.
49.	Ma WG, Ziganshin BA, Guo CF, et al. Does BioGlue contribute to anastomotic pseudoaneurysm after thoracic aortic surgery? J Thorac Dis, 2017, 9(8): 2491-2497.
50.	Takahara Y, Sudo Y, Mogi K, et al. Total aortic arch grafting for acute type A dissection: analysis of residual false lumen. Ann Thorac Surg, 2002, 73(2): 450-454.
51.	Liu ZG, Sun LZ, Chang Q, et al. Should the "elephant trunk" be skeletonized? Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection. J Thorac Cardiovasc Surg, 2006, 131(1): 107-113.

1. Chiappini B, Schepens M, Tan E, et al. Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients. Eur Heart J, 2005, 26(2): 180-186.
2. Moon MR. Approach to the treatment of aortic dissection. Surg Clin North Am, 2009, 89(4): 869-893.
3. Braverman AC. Aortic dissection: prompt diagnosis and emergency treatment are critical. Br J Hosp Med (Lond), 2017, 78(6): 320-326.
4. Redfern E, Callaway M, Zakkar M, et al. Improving outcomes in acute aortic dissection. Br J Hosp Med (Lond), 2017, 78(6): 320-326.
5. 尚蔚, 刘楠, 闫晓蕾, 等. A型主动脉夹层手术后早期并发症分析. 心肺血管病杂志, 2011, 30(3): 183-186.
6. 康凯, 张宇南, 谢宝栋, 等. 22例Stanford A型主动脉夹层手术止血技巧体会. 心肺血管病杂志, 2011, 30(6): 521-523.
7. Svensson LG, Crawford ES, Hess KR, et al. Dissection of the aorta and dissecting aortic aneurysms. Improving early and long-term surgical results. Circulation, 1990, 82(5 Suppl): I24-I38.
8. Fattori R, Bacchi-Reggiani L, Bertaccini P, et al. Evolution of aortic dissection after surgical repair. Am J Cardiol, 2000, 86(8): 868-872.
9. Bernard Y, Zimmermann H, Chocron S, et al. False lumen patency as a predictor of late outcome in aortic dissection. Am J Cardiol, 2001, 87(12): 1378-1382.
10. Moore NR, Parry AJ, Trottman-Dickenson B, et al. Fate of the native aorta after repair of acute type A dissection: a magnetic resonance imaging study. Heart, 1996, 75(1): 62-66.
11. Heijmen RH, Gründeman PF, Borst C. Intima-adventitia apposition in end-to-side arterial anastomosis: an experimental study in the pig. Ann Thorac Surg, 1998, 65(3): 705-711.
12. Sabik JF, Lytle BW, Blackstone EH, et al. Long-term effectiveness of operations for ascending aortic dissections. J Thorac Cardiovasc Surg, 2000, 119(5): 946-962.
13. Driever R, Botsios S, Schmitz E, et al. Long-term effectiveness of operative procedures for Stanford type A aortic dissections. Cardiovasc Surg, 2003, 11(4): 265-272.
14. Immer FF, Hagen U, Berdat PA, et al. Risk factors for secondary dilatation of the aorta after acute type A aortic dissection. Eur J Cardiothorac Surg, 2005, 27(4): 654-657.
15. Olsson C, Eriksson N, Ståhle E, et al. Surgical and long-term mortality in 2634 consecutive patients operated on the proximal thoracic aorta. Eur J Cardiothorac Surg, 2007, 31(6): 963-969.
16. Rylski B, Siepe M, Blanke P, et al. Adventitial inversion with graft telescopic insertion for distal anastomosis in acute type a aortic dissection. Ann Thorac Cardiovasc Surg, 2012, 18(3): 278-280.
17. Ohata T, Miyamoto Y, Mitsuno M, et al. Modified sandwich technique for acute aortic dissection. Asian Cardiovasc Thorac Ann, 2007, 15(3): 261-263.
18. 郭应强, 张尔永, 蒙炜, 等. 急性A型主动脉夹层手术主动脉断端加固方法的改进. 中国胸心血管外科临床杂志, 2009, 16(5): 389-391.
19. 秦卫, 黄福华, 陈鑫, 等. 不同主动脉断端加固方法在急性Stanford A型主动脉夹层手术中的应用. 中国胸心血管外科临床杂志, 2014, 21(3): 356-360.
20. Floten HS, Ravichandran PS, Furnary AP, et al. Adventitial inversion technique in repair of aortic dissection. Ann Thorac Surg, 1995, 59(3): 771-772.
21. García-Rinaldi R, Carballido J, Mojica J, et al. Surgical treatment of aortic dissections: initial experience with the adventitial inversion technique. Ann Thorac Surg, 1998, 65(5): 1255-1259.
22. Tanaka K, Morioka K, Li W, et al. Adventitial inversion technique without the aid of biologic glue or Teflon buttress for acute type A aortic dissection. Eur J Cardiothorac Surg, 2005, 28(6): 864-869.
23. Kim SW, Sung K, Lee YT, et al. Aortic false lumen patency following the adventitial inversion technique for acute DeBakey type Ⅰ aortic dissection. J Card Surg, 2010, 25(5): 548-553.
24. Oda T, Minatoya K, Sasaki H, et al. Adventitial inversion technique for type A aortic dissection distal anastomosis. J Thorac Cardiovasc Surg, 2016, 151(5): 1340-1345.
25. Tanaka K, Yamamoto K, Hiraiwa T, et al. Early and mid-term outcomes of surgical treatment with conservative approach using adventitial inversion technique for an acute type A aortic dissection. Kyobu Geka, 2016, 69(4): 257-262.
26. Oda K, Akimoto H, Hata M, et al. Use of cuffed anastomosis in total aortic arch replacement. Ann Thorac Surg, 2003, 76(3): 952-953.
27. Ogino H. Open repair of distal aortic arch and proximal descending thoracic aortic aneurysm using a stepwise distal anastomosis. Oper Tech Thorac Cardiovasc Surg, 2007, 12(3): 162-166.
28. 汪黎明, 陈鑫, 获野均. 逐步吻合式全弓置换术治疗伴有远端延伸的主动脉弓部瘤. 中华外科杂志, 2008, 46(7): 556-557.
29. Matsuyama S, Tabata M, Shimokawa T, et al. Outcomes of total arch replacement with stepwise distal anastomosis technique and modified perfusion strategy. J Thorac Cardiovasc Surg, 2012, 143(6): 1377-1381.
30. Inoue Y, Minatoya K, Itonaga T, et al. Utility of proximal stepwise technique for acute aortic dissection involving the aortic root. Ann Thorac Surg, 2016, 101(5): e183-e185.
31. Ogino H, Ando M, Sasaki H, et al. Total arch replacement using a stepwise distal anastomosis for arch aneurysms with distal extension. Eur J Cardiothorac Surg, 2006, 29(2): 255-257.
32. Imoto K. Recent status of gelatin-resorcin-formalin glue for acute type A aortic dissection. Gen Thorac Cardiovasc Surg, 2011, 59(5): 313-314.
33. Shiono M. Surgery for acute aortic dissection using gelatin-resorcin-formalin glue: perspective from 10 years of follow-up at a single center. J Artif Organs, 2008, 11(1): 19-23.
34. Fehrenbacher JW, Siderys H. Use of BioGlue in aortic surgery: proper application techniques and results in 92 patients. Heart Surg Forum, 2006, 9(5): E794-E799.
35. Rylski B, Bavaria JE, Milewski RK, et al. Long-term results of neomedia sinus valsalva repair in 489 patients with type A aortic dissection. Ann Thorac Surg, 2014, 98(2): 582-588.
36. Hoschtitzky JA, Crawford L, Brack M, et al. Acute coronary syndrome following repair of aortic dissection. Eur J Cardiothorac Surg, 2004, 26(4): 860-862.
37. von Oppell UO, Karani Z, Brooks A, et al. Dissected aortic sinuses repaired with gelatin-resorcin-formaldehyde (GRF) glue are not stable on follow up. J Heart Valve Dis, 2002, 11(2): 249-257.
38. Mastroroberto P, Chello M, Onorati F, et al. Embolisation, inflammatory reaction and persistent patent false lumen: is biological glue really effective in repair of type A aortic dissection? Eur J Cardiothorac Surg, 2005, 27(3): 531-532.
39. Suehiro K, Hata T, Yoshitaka H, et al. Late aortic root redissection following surgical treatment for acute type A aortic dissection using Gelatin-Resorcin-Formalin glue. Jpn J Thorac Cardiovasc Surg, 2002, 50(5): 195-200.
40. Bingley JA, Gardner MA, Stafford EG, et al. Late complications of tissue glues in aortic surgery. Ann Thorac Surg, 2000, 69(6): 1764-1768.
41. Kazui T, Washiyama N, Bashar AH, et al. Role of biologic glue repair of proximal aortic dissection in the development of early and midterm redissection of the aortic root. Ann Thorac Surg, 2001, 72(2): 509-514.
42. Luk A, David TE, Butany J. Complications of Bioglue postsurgery for aortic dissections and aortic valve replacement. J Clin Pathol, 2012, 65(11): 1008-1012.
43. Weiner J, Widman S, Golek Z, et al. Role of bovine serum albumin-glutaraldehyde glue in the formation of anastomatic pseudoaneurysms. J Card Surg, 2011, 26(1): 76-81.
44. Alameddine A, Alimov VK, Rousou JA, et al. Aortopulmonary artery disruption following acute type-A aortic dissection repair with the use of BioGlue®. J Card Surg, 2012, 27(3): 371-373.
45. Rubio Alvarez J, Sierra Quiroga J, Martinez de Alegria A, et al. Pulmonary embolism due to biological glue after repair of type A aortic dissection. Interact Cardiovasc Thorac Surg, 2011, 12(4): 650-651.
46. Kimura C, Takihara H, Okada S. Coronary embolism probably caused by surgical glue after operation for acute aortic dissection; report of a case. Kyobu Geka, 2016, 69(7): 548-551.
47. Furukawa H, Masaki H, Tanemoto K. Late limb embolization of biological glue after repair of aortic dissection. Eur J Cardiothorac Surg, 2015, 48(4): 633.
48. Kobayashi T, Kurazumi H, Sato M, et al. Pseudoaneurysm rupture after acute Type A dissection repair: possible reaction to BioGlue. Interact Cardiovasc Thorac Surg, 2018, 26(2): 331-332.
49. Ma WG, Ziganshin BA, Guo CF, et al. Does BioGlue contribute to anastomotic pseudoaneurysm after thoracic aortic surgery? J Thorac Dis, 2017, 9(8): 2491-2497.
50. Takahara Y, Sudo Y, Mogi K, et al. Total aortic arch grafting for acute type A dissection: analysis of residual false lumen. Ann Thorac Surg, 2002, 73(2): 450-454.
51. Liu ZG, Sun LZ, Chang Q, et al. Should the "elephant trunk" be skeletonized? Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection. J Thorac Cardiovasc Surg, 2006, 131(1): 107-113.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research progress on end-to-end anastomosis in surgical treatment of acute Stanford A aortic dissection

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