Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection

Acute type A aortic dissection (ATAAD) is a critical and life-threatening condition. To date, surgical intervention remains the primary life-saving treatment. However, this surgical approach is often accompanied by a range of postoperative complications, and the associated mortality rate remains high. In this study, we introduced an innovative technique that utilized tetrafurcate graft eversion for suturing and reinforcing the aortic root, in conjunction with a single-branched stent technique, for the management of ATAAD. A total of eighty-nine ATAAD patients who underwent surgical treatment at Ganzhou People’s Hospital between January 2021 and March 2024 were enrolled in this study. The patients were divided into two groups based on the surgical technique employed: a conventional group (n = 57) and an modified-technique group (n = 32). A comprehensive analysis of perioperative outcomes was conducted. There were no statistically significant differences in preoperative characteristics between the two groups. The intraoperative cardiopulmonary bypass (CPB) time, assisted-circulation time (ACT), and total operation time in the modified-technique group were significantly shorter than those in the conventional group (P = 0.027, P = 0.009, and P = 0.012, respectively). Moreover, patients in the modified-technique group had less drainage on the first postoperative day (P = 0.011), shorter ventilation time, intensive care unit (ICU) stay, and postoperative in-hospital stay (P = 0.014, P = 0.028, and P = 0.017, respectively), as well as a lower postoperative in-hospital mortality rate (P = 0.035)​. Combining tetrafurcate graft eversion for aortic root suturing and reinforcement with single-branched stent implantation offers a simplified, safe, and effective approach for treating ATAAD.