Is it justified to apply a modified Cabrol fistula in surgical repair of acute type A aortic dissection?

OBJECTIVE: Open repair of acute type A aortic dissection frequently results in oozing from the suture lines. A modified fistula technique was developed to rapidly control oozing and allow closing the chest immediately and safely. The efficiency of this modified fistula technique in surgical repair of acute type A aortic dissection was evaluated.

METHODS: This was a retrospective study. From January 2015 to December 2016, 172 patients with acute type A aortic dissection underwent emergency surgical repair in our center. Among them, 76 were treated with the modified Cabrol fistula technique (fistula group), and the others did not receive this modified technique (nonfistula group). The clinical data of all patients were retrospectively reviewed and analyzed.

RESULTS: The preoperative data, cardiopulmonary bypass time, aortic crossclamp time, selective cerebral perfusion, and lower body arrest time of the 2 groups were similar. The chest closure time was shorter in the fistula group. The postoperative drainage, amount of red blood cell transfusion, incidence of reopening for hemostasis, mechanical ventilation support time, duration of intensive care unit stay, incidence of postoperative dialysis, and 30-day mortality were significantly lower in the fistula group than in the nonfistula group.

CONCLUSIONS: During surgical repair of acute type A aortic dissection, a modified Cabral fistula technique can rapidly control oozing and effectively improve the short-term outcomes.