ABSTRACT
Objective To evaluate the clinical efficacy of "Z"type aortic sinus angioplasty in acute Stanford A aortic dissection with severe aortic valve insufficiency .Methods A total of 384 cases of acute Stanford A aortic dissection were ana-lyzed retrospectively from January 2014 to March 2018 at Wuhan Asian Heart Hospital Great Vascular Center.There were 56 cases with severe aortic valve insufficiency, with 40 males and 16 females, aged 32-72 years old, averaged(53.92 ±9.26) years old.The root treatment of the 56 patients were all simulated with the "Z"type aortic sinus angioplasty technique, with 3 cases of distal semi-aortic arch replacement and 53 cases of total aortic arch replacement(placed with "trunk"stent).Results The average cardiopulmonary bypass time of all patients was(175.0 ±43.5)min, cross-clamp time was(133.3 ±31.9)min, and circulatory arrest time was(26.9 ±2.7)min.The degree of aortic valve regurgitation was 0-Ⅰin all patients after surger-y.Patients were followed-up 3 months to 4 years, the degree of aortic valve regurgitation of 45 cases was 0, 8 cases wasⅠ, and 3 cases wasⅡ.After operation, transesophageal ultrasonography immediately examined 2 cases with residual dissection of aor-tic sinus.Followed-up 1.5 years and 2.0 years respectively, no aneurysm was formed, and the diameter of the sinus of the aor-ta was 4.2 cm and 4.5 cm, respectively.No reoperation due to aortic valve regurgitation and sinus conditions was found during the follow-up.Conclusion The "Z"type aortic sinus angioplasty technique has a good clinical effect in acute Stanford A aor-tic dissection with severe aortic valve insufficiency.The operation is simple, safe and effective, easy to grasp and develop.