title: Long-term results of modified sandwich repair of aortic root in 151 patients with acute type A aortic dissection.
abstract: Acute type A aortic dissection frequently induces aortic root disease; however, the optimal surgical strategy for aortic root dissection remains a challenge. The objective of this study was to introduce a novel technique for reconstruction of type A dissection to improve patient prognosis.
  
  
  
  We performed a retrospective review of 791 consecutive patients with acute type A aortic dissection between January 2003 and July 2015. Among these patients, 151 were selected (72% men, age 51.7 ± 9.8 years) to have the modified sandwich repair of aortic root dissection.
  
  
  
  The in-hospital mortality rate of the 151 patients was 6.6% (10/151). During a mean follow-up period of 52.7 ± 28.6 months, the survival rate was 100, 89.1 and 69.7% at 1, 5 and 10 years, respectively. Echocardiography and computed tomographic angiography were performed every year to monitor the pathological change in the aortic root. Freedom from severe aortic regurgitation at 5 years was 100%. No patients required reintervention due to dissection or pseudoaneurysm of the proximal aortic root.
  
  
  
  Aortic valve resuspension and repair of the sinus of Valsalva with the modified sandwich technique using Teflon felt strips for acute type A dissection could be reliable and effective.
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, The Second Military Medical College, Shanghai 200433, China.
authors.forename: Yangfeng
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, The Second Military Medical College, Shanghai 200433, China.
authors.forename: Zilin
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, The Second Military Medical College, Shanghai 200433, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, The Second Military Medical College, Shanghai 200433, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Tang
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, The Second Military Medical College, Shanghai 200433, China.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Song
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, The Second Military Medical College, Shanghai 200433, China.
authors.forename: Zhiyun
authors.initials: Z
authors.lastname: Xu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002681:China / Q000453:epidemiology; D000072226:Computed Tomography Angiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Aortic dissection; Sandwich; Sinus of Valsalva