Hybrid Aortic Arch Repair For Patients Older Than 60 Years In Type A Acute Aortic Dissection

Background The objective of this study was to compare clinical outcomes of total arch replacement combined with stented elephant trunk implantation and hybrid aortic arch repair for type A acute aortic dissection in patients older than 60 years. Patients and Methods We studied records of patients with type A acute aortic dissection older than 60 years in our hospital between January 2016 and December 2018. 68 patients underwent total arch replacement combined with stented elephant trunk implantation (stented elephant trunk group) and 56 patients underwent hybrid aortic arch repair (hybrid group). Outcomes included operative data, postoperative data and 2 years of follow-up data. Results Comparing with stented elephant trunk group, hybrid group experienced shorter time on surgery duration (p < 0.001), cardiopulmonary bypass (p < 0.001), aortic cross-clamp (p < 0.001), mechanical ventilation (p < 0.001), ICU stay (p < 0.001), and hospital length of stay (p < 0.001). Hybrid group showed lower rate of pulmonary infection and renal failure (p = 0.023; p = 0.022, respectively). Blood product use was less in hybrid group (p < 0.001). Hybrid group had a trend toward reducing 30-day mortality rate, stroke, and transient mental dysfunction. And hybrid group had a trend toward improving 2-year survival rate and reintervention-free rate, but the results did not reach significant level. Conclusion Hybrid procedure could be safely performed in patients older than 60 years with type A acute aortic dissection. This procedure may be associated with encouraging surgical results and promising outcomes in early and mid-term.

Publikationsverlauf

Eingereicht: 28. Mai 2025

Angenommen nach Revision: 21. Dezember 2025

Accepted Manuscript online:
24. Dezember 2025