Total Arch Replacement is Safe as Hemiarch Repair in Acute Type A Aortic Dissection in a Middle-Income Country Setting

This study compares two surgical approaches for treating acute type A aortic dissection (ATAAD): hemiarch repair and total arch replacement (TAR). ATAAD is a life-threatening condition requiring immediate surgery. The study investigates whether TAR, a more extensive surgery, increases the risk of early complications compared to hemiarch repair. It also examines if TAR offers benefits like reducing the need for future operations. Researchers analyzed data from 107 patients who underwent either hemiarch repair or TAR for ATAAD. They looked at outcomes like stroke, spinal cord injury, in-hospital mortality, and the need for reoperation.

• 1
  The study found no significant differences in early mortality, stroke rate, or spinal cord injury between patients undergoing hemiarch repair and those undergoing total arch replacement.
• 2
  Bleeding reoperation was more frequent in the hemiarch group (30% vs. 11%), suggesting that the extended repair of TAR may offer benefits in terms of reducing the risk of reoperation.
• 3
  The duration of cardiopulmonary bypass was significantly longer in the TAR group, and the total length of hospital stay was also longer for TAR patients.