Comparing unilateral and bilateral cerebral perfusion during total arch replacement for acute type A aortic dissection.

Objectives: To assess the effects of unilateral versus bilateral antegrade cerebral perfusion (u-ACP vs b-ACP) on postoperative complications and mid-term follow-up results in Asian patients with acute type A aortic dissection (ATAAD) undergoing total arch replacement (TAR) + the frozen elephant trunk (FET).

Methods: Clinical baseline data and postoperative complications of 702 ATAAD patients undergoing TAR+ FET at China Cardiovascular Centre Fuwai Hospital between January 2019 and December 2022 were collected. Patients were categorized into two groups based on antegrade cerebral perfusion: unilateral (n = 402) and bilateral (n = 300).

Long-term outcomes in total arch replacement combined with frozen elephant trunk for acute type A aortic dissection.

Objective: The optimal surgical approach for acute type A aortic dissection involving the aortic arch remains controversial. This study aims to evaluate the long-term outcomes of acute type A aortic dissection treated with total arch replacement combined with frozen elephant trunk implantation in a large single-center cohort.

Methods: From 2010 to 2022, patients with acute type A aortic dissection who received total arch replacement with frozen elephant trunk implantation at Fuwai Hospital were selected for clinical data collection and long-term follow-up.

Comparative analysis of long-term outcomes in thoracoabdominal aortic aneurysm repair between Marfan syndrome patients and non-Marfan syndrome patients.

Background: A consensus on the management of thoracoabdominal aortic aneurysm (TAAA) in patients with Marfan syndrome (MFS) has not yet been established. This study aimed to compare the long-term outcomes after open TAAA repair in patients with and without MFS.

Methods: This retrospective study examined 230 consecutive patients who underwent TAAA repair between 2012 and 2022, including of 69 MFS patients and 161 non-MFS patients.

A unique technique for thoracoabdominal aortic repair for 10 years: Normothermic iliac perfusion.

Background: The modality of thoracoabdominal aortic repair (TAAR) is mainly based on left heart bypass (LHB) in western countries, while in our team, it is mainly based on a unique technique, normothermic iliac perfusion, and there is a lack of systematic reports and long-term results. To describe the operative technique and summarize the patient characteristics and outcomes of TAAR with normothermic iliac perfusion in our team in the last decade. Meanwhile, to explore the influence of different previous surgical history on prognosis.

The optimal degree of core temperature for hypothermic circulatory arrest in complex aortic arch surgery: results from 1310 patients.

Objectives: The optimal core temperature for hypothermic circulatory arrest during aortic arch surgery remains contentious. This study aims to evaluate patient outcomes under various temperatures within a large single-centre cohort.

Methods: Between 2010 and 2018, patients diagnosed with type A aortic dissection underwent total arch replacement at Fuwai Hospital were enrolled.

Aortic diameter remodeling after frozen elephant trunk as a predictor of early outcomes in thoracoabdominal aortic repair.

Objective: Patients who underwent previous frozen elephant trunk implantation for Stanford type A aortic dissection remain at risk for secondary intervention due to unsuccessful distal aortic remodeling. We aimed to investigate the impact of distal aortic remodeling on early outcomes in patients who underwent 2-stage thoracoabdominal aortic repair.

Methods: A total of 106 patients who previously underwent frozen elephant trunk implantation and thoracoabdominal aortic repair between October 2014 and December 2022 were enrolled in this study.

Systematic Review of the Application of Computational Fluid Dynamics for Adult Aortic Diseases.

Background: Computational fluid dynamics (CFD) is a new medical method combining medicine and science. The aim of this study is to summarize and analyze the application of CFD in adult aortic diseases.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Long-term outcomes of extensive thoracoabdominal aortic aneurysm repair utilizing normothermic iliac perfusion: A retrospective cohort study with 10-year single-center experience.

Background: Normothermic iliac perfusion has been increasingly utilized for TAAA repair; however, the long-term outcomes in large samples are lacking. This study was designed to assesses the perioperative and long-term results of thoracoabdominal aortic repair using normothermic iliac perfusion.

Methods: We retrospectively analyzed 156 patients having Crawford extent II or III thoracoabdominal aortic aneurysm replacement with normothermic iliac perfusion from 2012 to 2022.

Clinical outcomes of aortic root repair using pericardial autograft for acute type a aortic dissection.

Background: For acute type A aortic dissection involving the aortic root with root diameter no more than 45 mm, there are various aortic root repair techniques. In this study, a novel surgical technique using a pericardial autograft for aortic root repair was introduced. We described its surgical steps in detail and compare its clinical outcomes with direct suture technique.

Safety and effectiveness of the sutureless integrated stented graft prosthesis in an animal model.

Background: Prolonged circulatory arrest time is an independent risk factor for postoperative adverse events of type A aortic dissection (TAAD) surgery. Further reduction of the circulatory arrest time is essential to improve surgical outcomes. This study aimed to evaluate the safety and effectiveness of the novel Sutureless Integrated Stented (SIS) graft prosthesis in an animal experiment.

HSPB6 Deficiency Promotes the Development of Aortic Dissection and Rupture.

To better understand the pathogenesis of acute type A aortic dissection, high-sensitivity liquid chromatography-tandem mass spectrometry/mass spectrometry (LC-MS/MS)-based proteomics and phosphoproteomics approaches were used to identify differential proteins. Heat shock protein family B (small) member 6 (HSPB6) in aortic dissection was significantly reduced in human and mouse aortic dissection samples by real-time PCR, western blotting, and immunohistochemical staining techniques. Using an HSPB6-knockout mouse, we investigated the potential role of HSPB6 in β-aminopropionitrile monofumarate-induced aortic dissection.

A novel classification, management and long-term outcomes of coronary artery involvement in acute aortic dissection.

Background: To introduce a new and simple classification and management of coronary artery involvement in aortic dissection and report results.

Methods: Coronary artery involvement was classified into two types according to the integrity of coronary intima: simple lesion (type S) and complex lesion (type C). Complex lesions were treated by CABG and simple lesions were treated by ostial repair or reimplantation.

Calcium promotes vascular smooth muscle cell phenotypic switching in Marfan syndrome.

Fibrillin 1 (Fbn1) mutations cause Marfan syndrome (MFS), with aortic root dilatation, dissection, and rupture. Few studies reported the blood calcium and lipid profile of MFS, and the effect of vascular smooth muscle cell (VSMC) phenotypic switching on MFS aortic aneurysm is unclear. Here, we aimed to investigate the role of calcium-related VSMC phenotypic switching in MFS.

Current Surgical Management of Acute Type A Aortic Dissection in China: A Multicenter Registry Study.

Background: Many countries and regions have established multicenter registration studies to improve the outcomes of acute type A aortic dissection (ATAAD).

Objectives: The aims of this study were to report actual preoperative management, surgery type, and early outcomes of surgical treatment for ATAAD in China.

Methods: This cohort study uses data from the China Registry of Type A Aortic Dissection, a national clinical registry to investigate management of patients with Stanford type A aortic dissection.

Impact of frozen elephant trunk on the outcomes of thoracoabdominal aortic repair with normothermic iliac perfusion.

Background: Frozen elephant trunk technique (FET) has been proven to provide an excellent landing zone for second-stage thoracoabdominal (TA) aortic repair. The aim of this study was to evaluate the impact of FET in TA aortic repair with normothermic iliac perfusion.

Methods: From January 2008 to December 2019, 144 patients undergoing TA repair with normothermic iliac perfusion were enrolled in this study.

Visceral protection in total arch replacement for aortic dissection: Effect of lower body hypothermia.

Objective: Optimal hypothermia strategy for total arch replacement in acute type A aortic dissection (ATAAD) is unclear. A higher temperature during circulatory arrest might reduce tolerance to ischemia for visceral organs. We sought to investigate the effect of hypothermia on visceral protection.

The impact of prophylactic ascending aorta replacement on the long-term prognosis of zone 0 hybrid arch repair.

Objectives: To investigate the impact of prophylactic zone 0 replacement with prosthetic grafts on the long-term prognosis and perioperative safety of zone 0 hybrid arch repair (HAR) when zone 0 is neither dilated nor pathologic.

Methods: We retrospectively reviewed 115 patients whose zone 0 aorta was neither dilated nor pathologic and who underwent zone 0 HAR from January 2009 to December 2020 and divided then into two groups depending on whether zone 0 was replaced, with 46 patients in the no-replacement group and 69 patients in the replacement group. Inverse probability of treatment weighting (IPTW) was used to balance the baseline difference, and outcomes were compared after IPTW adjustment.

Outcomes of one-staged procedures to treat aortic coarctation complicated by cardiac anomalies.

Objective: One-staged surgical treatment of aortic coarctation combined with cardiac anomalies is challenging. We aim to evaluate the feasibility of bilateral aortofemoral bypass technique in one-staged surgery treating coractation by comparing surgical outcomes with catheter intervention plus stent (hybrid).

Methods: Between January 2012 and December 2017, 50 patients underwent one-staged surgical procedures to treat coarctation and repair concomitant cardiac anomalies, like aortic root dilatation, cardiac valvular disease and so on.

Does methylprednisolone provide protective effect in total aortic arch replacement requiring hypothermia circulatory arrest and selective cerebral perfusion?

Background: Glucocorticoids (GC)were applied in total aortic arch replacement (TAAR) at various dosages in many centers, but with limited evidence.

Methods: The retrospective study was aimed to evaluate whether methylprednisolone was associated with better postoperative outcomes in patients undergoing TAAR. Patients undergoing TAAR with moderate hypothermia and selective cerebral perfusion between 2017.

Prediction Nomogram for Postoperative 30-Day Mortality in Acute Type A Aortic Dissection Patients Receiving Total Aortic Arch Replacement With Frozen Elephant Trunk Technique.

Objective: To develop and validate a nomogram model to predict postoperative 30-day mortality in acute type A aortic dissection patients receiving total aortic arch replacement with frozen elephant trunk technique.

Method: Clinical data on 1,156 consecutive acute type A aortic dissection patients who got total aortic arch replacement using the frozen elephant trunk technique was collected from January 2010 to December 2020. These patients were divided into training and testing cohorts at random with a ratio of 7:3.

Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology.

Background: The hybrid arch repair (HAR) is an appealing surgical option in the management of aortic arch diseases. The aim is to evaluate the short and mid-term outcomes of type II HAR involving replacement of the ascending aorta, arch debranching, and zone 0 stent graft deployment in diverse arch pathologies.

Methods: 200 patients with various diffuse aortic pathologies involving the arch were enrolled between 2016 and 2019.