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Short-term Outcomes of Modified Y-Graft Technique in Acute Type A Aortic Dissection Using the Femoral Artery Bypass and One Minute Systemic Circulatory Arrest Technique
Wenyu Sun
Department of cardiovascular surgery, Qilu Hospital of Shandong University
Corresponding Author
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Objective: Aortic arch replacement in acute type A aortic dissection patients remains the most challenging cardiovascular operation. Herein, we described our modified Y-graft technique using the Femoral Artery Bypass (FAB) and the One Minute Systemic Circulatory Arrest (OSCA) technique, and assessed the short-term outcomes of the patients.
Methods: Between February 2015 and November 2017, 51 patients with acute type A aortic dissection underwent aortic arch replacement. Among them, 23 patients underwent FAB while 28 patients underwent both FAB and OSCA. The intraoperative data and postoperative follow-up data were recorded. The follow-up data of patients with traditional Y-graft technique were collected from previously reported studies.
Results: In the FAB group, two patients died due to pulmonary infection (30-day survival rate, 91.3%), and two patients were paralyzed from the waist down. Hemodialysis was performed for five patients (21.7%) before hospital discharge. Fifteen patients (65.2%) received respiratory support for more than 2-days and eight patients (34.8%) for more than 5-days. These follow-up results were comparable or better than the patients with traditional Y-graft technique. Furthermore, compared to the FAB group, the morbidity due to neurological dysfunction and acute renal failure was significantly reduced in the FAB+OSCA group. Moreover, the respiratory support, length of postoperative stay and ICU stay were shortened.
Conclusions: This study clarified the feasibility of FAB and OSCA technique in modifying Y-graft technique. The acute type A aortic dissection patients showed less surgical complications and favorable short-term outcomes after this surgery.
Keywords
modified Y-graft technique, femoral artery bypass, one minute systemic circulatory arrest, acute type A aortic dissection
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CURRENT STATUS: Under Review
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Posted 20 May, 2020
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Editor assigned
On 11 May, 2020
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On 10 May, 2020
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On 10 May, 2020
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Received 29 Mar, 2020
Editorial decision: Major revision
On 29 Mar, 2020
Review #2 received
Received 27 Mar, 2020
Review #4 received
Received 27 Mar, 2020
Reviewer #4 agreed
On 26 Mar, 2020
Reviewer #2 agreed
On 25 Mar, 2020
Reviewer #3 agreed
On 25 Mar, 2020
Reviewers invited
Invitations sent on 22 Mar, 2020
Reviewer #1 agreed
On 22 Mar, 2020
Editor assigned
On 25 Feb, 2020
First submitted
On 24 Feb, 2020
Submission checks complete
On 24 Feb, 2020
Editor invited
On 24 Feb, 2020
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This preprint is under consideration at Journal of Cardiothoracic Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Short-term Outcomes of Modified Y-Graft Technique in Acute Type A Aortic Dissection Using the Femoral Artery Bypass and One Minute Systemic Circulatory Arrest Technique
Wenyu Sun
Department of cardiovascular surgery, Qilu Hospital of Shandong University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 20 May, 2020
No community comments so far
Editor assigned
On 11 May, 2020
Submission checks complete
On 10 May, 2020
Editor invited
On 10 May, 2020
No comments provided
Review #1 received
Received 29 Mar, 2020
Editorial decision: Major revision
On 29 Mar, 2020
Review #2 received
Received 27 Mar, 2020
Review #4 received
Received 27 Mar, 2020
Reviewer #4 agreed
On 26 Mar, 2020
Reviewer #2 agreed
On 25 Mar, 2020
Reviewer #3 agreed
On 25 Mar, 2020
Reviewers invited
Invitations sent on 22 Mar, 2020
Reviewer #1 agreed
On 22 Mar, 2020
Editor assigned
On 25 Feb, 2020
First submitted
On 24 Feb, 2020
Submission checks complete
On 24 Feb, 2020
Editor invited
On 24 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiothoracic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: Aortic arch replacement in acute type A aortic dissection patients remains the most challenging cardiovascular operation. Herein, we described our modified Y-graft technique using the Femoral Artery Bypass (FAB) and the One Minute Systemic Circulatory Arrest (OSCA) technique, and assessed the short-term outcomes of the patients.
Methods: Between February 2015 and November 2017, 51 patients with acute type A aortic dissection underwent aortic arch replacement. Among them, 23 patients underwent FAB while 28 patients underwent both FAB and OSCA. The intraoperative data and postoperative follow-up data were recorded. The follow-up data of patients with traditional Y-graft technique were collected from previously reported studies.
Results: In the FAB group, two patients died due to pulmonary infection (30-day survival rate, 91.3%), and two patients were paralyzed from the waist down. Hemodialysis was performed for five patients (21.7%) before hospital discharge. Fifteen patients (65.2%) received respiratory support for more than 2-days and eight patients (34.8%) for more than 5-days. These follow-up results were comparable or better than the patients with traditional Y-graft technique. Furthermore, compared to the FAB group, the morbidity due to neurological dysfunction and acute renal failure was significantly reduced in the FAB+OSCA group. Moreover, the respiratory support, length of postoperative stay and ICU stay were shortened.
Conclusions: This study clarified the feasibility of FAB and OSCA technique in modifying Y-graft technique. The acute type A aortic dissection patients showed less surgical complications and favorable short-term outcomes after this surgery.
Figure 1
Figure 2
Figure 3
Figure 4