Novel Surgical Technique Promising in Improving Outcomes for Acute Type A Aortic Dissection: Study
China: A novel surgical technique combining tetrafurcate graft eversion suturing with a single-branched stent has demonstrated encouraging outcomes in patients with acute type A aortic dissection (ATAAD), according to a recent study published in BMC Surgery. The research was led by Dr. Zulei Zhang and colleagues from the Department of Cardiovascular Surgery at Ganzhou People’s Hospital, Jiangxi Province.
ATAAD is a life-threatening emergency that demands urgent surgical intervention. Despite advancements, traditional procedures continue to carry significant risks, including prolonged operation times, complications, and high mortality. Seeking to improve patient outcomes, the researchers introduced a modified technique aimed at simplifying the procedure and enhancing postoperative recovery.
The study retrospectively analyzed data from 89 patients treated for ATAAD at the hospital between January 2021 and March 2024. Patients were divided into two groups: 57 underwent the conventional surgical method, while 32 received the new approach using tetrafurcate graft eversion for aortic root suturing combined with a single-branched stent.
Key findings revealed the following:
- The modified technique group had significantly shorter cardiopulmonary bypass time.
- There was a notable reduction in assisted circulation time in the modified technique group.
- The total duration of surgery was shorter in patients who received the modified procedure.
- Patients experienced lower drainage volumes on the first postoperative day.
- Ventilator weaning occurred more quickly in the modified technique group.
- Intensive care unit (ICU) stay was shorter among these patients.
- There was also a reduction in postoperative hospital stay.
- The in-hospital mortality rate was significantly lower in the modified technique group.
“The results highlight that this combined technique not only simplifies the operative process but also minimizes surgical trauma and supports faster recovery,” stated Dr. Zhang. “These findings suggest it could serve as a valuable alternative to conventional methods in managing ATAAD.”
The study emphasized that the improved efficiency and reduced complication rates make this technique suitable for broader clinical adoption. However, the researchers acknowledged certain limitations, including the retrospective, non-randomized design and relatively small sample size, which restricted more rigorous statistical comparisons such as propensity score matching.
To strengthen their conclusions, the team plans to pursue randomized controlled trials with a larger cohort and extended follow-up to better assess the long-term benefits and potential risks of the new method.
“Despite the limitations, the outcomes of our study reinforce the importance of continuous innovation in cardiovascular surgery,” the authors noted. “Our technique presents a safer and more effective strategy for ATAAD and underscores the need for further research to refine surgical protocols.”
"As ATAAD continues to pose serious challenges in cardiac surgery, the findings from this Chinese team add a promising perspective to improving patient survival and quality of care," the authors concluded.
Reference:
Zhang, Z., Cai, L., Zhong, F. et al. Tetrafurcate graft Eversion suturing combined with single-branched stent technique in surgical repair of acute type A aortic dissection. BMC Surg 25, 307 (2025). https://doi.org/10.1186/s12893-025-03052-y
