Clinical Outcomes of VasoRing Connector in Patients With Acute Type A Aortic Dissection

Ann Thorac Surg. 2018 Sep;106(3):764-770. doi: 10.1016/j.athoracsur.2018.03.056. Epub 2018 Apr 26.

Abstract

Background: Outcomes of acute type A aortic dissection repair may be improved when VasoRing connectors (VRC [Sunwei Technology, Taipei, Taiwan]) are used to facilitate aortic anastomosis. In the present study, we compared the results of acute type A aortic dissection repair using VRC and conventional suture technique.

Methods: A total of 68 patients who underwent acute type A aortic dissection repair by total arch replacement and antegrade frozen elephant trunk procedure at our institution were enrolled. Records of patients receiving aorta anastomosis with VRC (n = 33) and conventional suture (n = 35) were retrospectively compared. All the surgical results were collected and analyzed.

Results: The results showed that the VRC group exhibited significance in total operative time (326 ± 80 minutes versus 362 ± 34 minutes, p = 0.023), cardiopulmonary bypass time (97 ± 10 minutes versus 134 ± 15 minutes, p < 0.001), aortic cross-clamp time (97 ± 10 minutes versus 134 ± 15 minutes, p < 0.001), and circulatory arrest time (15 ± 4 minutes versus 50 ± 8 minutes, p < 0.001) compared with the suture group. Use of VRC for aortic anastomosis led to significantly less perioperative blood loss (442 ± 75 mL versus 849 ± 419 mL, p < 0.001) compared with conventional suture for aortic anastomosis There was no reoperation for postoperative bleeding in the VRC group whereas reoperation for postoperative bleeding occurred in 20% of the suture group (0% versus 20%, p = 0.011). Postoperative blood loss, amount of blood transfusion, and acute kidney injury requiring hemodialysis were also significantly less in the VRC group than the suture group.

Conclusions: Use of VRC shortened operative time and improved bleeding control incorporating standard methods for aortic anastomoses during acute type A aortic dissection repair by total arch replacement and antegrade frozen elephant trunk procedure. Long-term follow-up and randomized comparison are needed to confirm VRC efficacy.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Aged
  • Anastomosis, Surgical / instrumentation
  • Anastomosis, Surgical / methods
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / mortality
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / mortality*
  • Aortic Dissection / surgery*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation / methods*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Length of Stay
  • Male
  • Middle Aged
  • Operative Time
  • Prosthesis Design
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Sternotomy / methods
  • Survival Rate
  • Suture Techniques
  • Taiwan
  • Treatment Outcome