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Published in: Journal of Cardiothoracic Surgery 1/2021

Open Access 01-12-2021 | Aortic Dissection | Research article

Quality of life: modified triple-branched stent graft implantation versus frozen elephant trunk technique

Authors: Zeng-Rong Luo, Mi-Rong Tang, Jia-Hui Li, Liang-Wan Chen, Liang-Liang Yan

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

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Abstract

Objective

To compare the effects of modified triple-branched stent implantation and frozen elephant trunk technique on the quality of life (QoL) of acute Stanford Type A aortic dissection (AAAD) patients at different follow-up times.

Methods

Data from 175 AAAD survivors was collected which were divided into two groups according to different surgical techniques: (group A): modified triple-branched stent graft implantation; (group B): frozen elephant trunk. The SF-36 were used to assess the QoL at discharge (AD), the third postoperative month (POM3), and the twelfth postoperative month (POM12).

Results

(1) The total scores at each time of both groups showed lower than the normal level; Group A scored higher than group B at some time points in terms of some items (role physical, role emotion and mental health; all P = 0.000), and some items at POM3 or POM12 scored higher than at discharge (role physical, social function; both P = 0.000). (2) There were less patients with heavy self-perceived burden in group A than group B at discharge (P = 0.032) and patients with heavy self-perceived burden decreased over time. (3) Young postoperative AAD patients (P = 0.002) in group B (P = 0.005) with heavy self-perceived burden (P = 0.000), acute renal failure (P = 0.008), long LOS (P = 0.026) and blood loss (> 1000 mL/24 h) (P = 0.039) seemed to get a worse QoL.

Conclusion

The impact on QoL of the modified triple-branched stent graft implantation technique seemed to be better than those of frozen elephant trunk surgery in role physical, role emotion and mental health.
Literature
1.
go back to reference Cook RC, Gao M, Macnab AJ, et al. Aortic arch reconstruction: safety of moderate hypothermia and antegrade cerebral perfusion during systemic circulatory arrest. J Card Surg. 2006;21:158–64.CrossRef Cook RC, Gao M, Macnab AJ, et al. Aortic arch reconstruction: safety of moderate hypothermia and antegrade cerebral perfusion during systemic circulatory arrest. J Card Surg. 2006;21:158–64.CrossRef
2.
go back to reference Weigang E, Nienaber CA, Rehders TC, et al. Management of patients with aortic dissection. Dtsch Arztebl Int. 2008;105:639–45.PubMedPubMedCentral Weigang E, Nienaber CA, Rehders TC, et al. Management of patients with aortic dissection. Dtsch Arztebl Int. 2008;105:639–45.PubMedPubMedCentral
3.
go back to reference Suzuki S, Masuda M. An update on surgery for acute type A aortic dissection: aortic root repair, endovascular stent graft, and genetic research. Surg Today. 2009;39:281–9.CrossRef Suzuki S, Masuda M. An update on surgery for acute type A aortic dissection: aortic root repair, endovascular stent graft, and genetic research. Surg Today. 2009;39:281–9.CrossRef
4.
go back to reference Peach G, Holt P, Loftus I, et al. Questions remain about quality of life after abdominal aortic aneurysm repair. J Vasc Surg. 2012;56:520–7.CrossRef Peach G, Holt P, Loftus I, et al. Questions remain about quality of life after abdominal aortic aneurysm repair. J Vasc Surg. 2012;56:520–7.CrossRef
5.
go back to reference Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.CrossRef Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.CrossRef
6.
go back to reference Chen LW, Dai XF, Wu XJ, et al. Ascending aorta and hemiarch replacement combined with modified triple-branched stent graft implantation for repair of acute deBakey type I aortic dissection. Ann Thorac Surg. 2017;103:595–601.CrossRef Chen LW, Dai XF, Wu XJ, et al. Ascending aorta and hemiarch replacement combined with modified triple-branched stent graft implantation for repair of acute deBakey type I aortic dissection. Ann Thorac Surg. 2017;103:595–601.CrossRef
7.
go back to reference Sun LZ, Liu ZG, Chang Q, et al. Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection. Zhonghua Wai Ke Za Zhi. 2004;42:812–6.PubMed Sun LZ, Liu ZG, Chang Q, et al. Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection. Zhonghua Wai Ke Za Zhi. 2004;42:812–6.PubMed
8.
go back to reference Sjögren J, Thulin LI. Quality of life in the very elderly after cardiac surgery: a comparison of SF-36 between long-term survivors and an age-matched population. Gerontology. 2004;50:407–10.CrossRef Sjögren J, Thulin LI. Quality of life in the very elderly after cardiac surgery: a comparison of SF-36 between long-term survivors and an age-matched population. Gerontology. 2004;50:407–10.CrossRef
9.
go back to reference Accola KD, Scott ML, Spector SD, et al. Is the St. Jude Medical mechanical valve an appropriate choice for elderly patients?: a long-term retrospective study measuring quality of life. J Heart Valve Dis. 2006;15:57–66.PubMed Accola KD, Scott ML, Spector SD, et al. Is the St. Jude Medical mechanical valve an appropriate choice for elderly patients?: a long-term retrospective study measuring quality of life. J Heart Valve Dis. 2006;15:57–66.PubMed
10.
go back to reference Sedrakyan A, Vaccarino V, Paltiel AD, et al. Age does not limit quality of life improvement in cardiac valve surgery. J Am Coll Cardiol. 2003;42:1208–14.CrossRef Sedrakyan A, Vaccarino V, Paltiel AD, et al. Age does not limit quality of life improvement in cardiac valve surgery. J Am Coll Cardiol. 2003;42:1208–14.CrossRef
11.
go back to reference Zhang X, Xia R, Wang S, et al. Relative contributions of different lifestyle factors to health-related quality of life in the elderly. Int J Environ Res Public Health. 2018;15:256.CrossRef Zhang X, Xia R, Wang S, et al. Relative contributions of different lifestyle factors to health-related quality of life in the elderly. Int J Environ Res Public Health. 2018;15:256.CrossRef
12.
go back to reference Xiao Y, Wang H, Zhang T, et al. Psychosocial predictors of physical activity and health-related quality of life among Shanghai working adults. Health Qual Life Outcomes. 2019;17:72.CrossRef Xiao Y, Wang H, Zhang T, et al. Psychosocial predictors of physical activity and health-related quality of life among Shanghai working adults. Health Qual Life Outcomes. 2019;17:72.CrossRef
13.
go back to reference Sedrakyan A, Hebert P, Vaccarino V, et al. Quality of life after aortic valve replacement with tissue and mechanical implants. J Thorac Cardiovasc Surg. 2004;128:266–72.CrossRef Sedrakyan A, Hebert P, Vaccarino V, et al. Quality of life after aortic valve replacement with tissue and mechanical implants. J Thorac Cardiovasc Surg. 2004;128:266–72.CrossRef
14.
go back to reference Cousineau N, McDowell I, Hotz S, et al. Measuring chronic patients’ feelings of being a burden to their caregivers: development and preliminary validation of a scale. Med Care. 2003;41:110–8.CrossRef Cousineau N, McDowell I, Hotz S, et al. Measuring chronic patients’ feelings of being a burden to their caregivers: development and preliminary validation of a scale. Med Care. 2003;41:110–8.CrossRef
15.
go back to reference Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Masuda M, et al. Thoracic and cardiovascular surgery in Japan during 2013: Annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2015;63:670-701. Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Masuda M, et al. Thoracic and cardiovascular surgery in Japan during 2013: Annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2015;63:670-701.
16.
go back to reference David TE, Feindel CM, Webb GD, et al. Long-term results of aortic valve-sparing operations for aortic root aneurysm. J Thorac Cardiovasc Surg. 2006;132:347–54.CrossRef David TE, Feindel CM, Webb GD, et al. Long-term results of aortic valve-sparing operations for aortic root aneurysm. J Thorac Cardiovasc Surg. 2006;132:347–54.CrossRef
17.
go back to reference Yacoub MH, Gehle P, Chandrasekaran V, et al. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg. 1998;115:1080–90.CrossRef Yacoub MH, Gehle P, Chandrasekaran V, et al. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg. 1998;115:1080–90.CrossRef
18.
go back to reference Kallenbach K, Hagl C, Walles T, et al. Results of valve-sparing aortic root reconstruction in 158 consecutive patients. Ann Thorac Surg. 2002;74:2026–32.CrossRef Kallenbach K, Hagl C, Walles T, et al. Results of valve-sparing aortic root reconstruction in 158 consecutive patients. Ann Thorac Surg. 2002;74:2026–32.CrossRef
19.
go back to reference Karck M, Kallenbach K, Hagl C, et al. Aortic root surgery in Marfan syndrome: comparison of aortic valve-sparing reimplantation versus composite grafting. J Thorac Cardiovasc Surg. 2004;127:391–8.CrossRef Karck M, Kallenbach K, Hagl C, et al. Aortic root surgery in Marfan syndrome: comparison of aortic valve-sparing reimplantation versus composite grafting. J Thorac Cardiovasc Surg. 2004;127:391–8.CrossRef
20.
go back to reference Aicher D, Langer F, Kissinger A, et al. Valve-sparing aortic root replacement in bicuspid aortic valves: a reasonable option? J Thorac Cardiovasc Surg. 2004;128:662–8.CrossRef Aicher D, Langer F, Kissinger A, et al. Valve-sparing aortic root replacement in bicuspid aortic valves: a reasonable option? J Thorac Cardiovasc Surg. 2004;128:662–8.CrossRef
21.
go back to reference Urbach DR. Measuring quality of life after surgery. Surg Innov. 2005;12:161–5.CrossRef Urbach DR. Measuring quality of life after surgery. Surg Innov. 2005;12:161–5.CrossRef
22.
go back to reference The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med. 1998;46:1569–85. The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med. 1998;46:1569–85.
23.
go back to reference Hanestad BR, Albrektsen G. The effects of participation in a support group on self-assessed quality of life in people with insulin-dependent diabetes mellitus. Diabetes Res Clin Pract. 1993;19:163–73.CrossRef Hanestad BR, Albrektsen G. The effects of participation in a support group on self-assessed quality of life in people with insulin-dependent diabetes mellitus. Diabetes Res Clin Pract. 1993;19:163–73.CrossRef
24.
go back to reference Farquhar M. Definitions of quality of life: a taxonomy. J Adv Nurs. 1995;22:502–8.CrossRef Farquhar M. Definitions of quality of life: a taxonomy. J Adv Nurs. 1995;22:502–8.CrossRef
25.
go back to reference Ghazy T, Eraqi M, Mahlmann A, et al. Quality of life after surgery for Stanford type A aortic dissection: influences of different operative strategies. Heart Surg Forum. 2017;20:E102–6.CrossRef Ghazy T, Eraqi M, Mahlmann A, et al. Quality of life after surgery for Stanford type A aortic dissection: influences of different operative strategies. Heart Surg Forum. 2017;20:E102–6.CrossRef
26.
go back to reference Piccardo A, Regesta T, Le Guyader A, et al. Outcomes after surgery for acute type A aortic dissection in “non-Marfan syndrome” patients with long life expectancy: a 24-year follow-up. Arch Cardiovasc Dis. 2017;110:14–25.CrossRef Piccardo A, Regesta T, Le Guyader A, et al. Outcomes after surgery for acute type A aortic dissection in “non-Marfan syndrome” patients with long life expectancy: a 24-year follow-up. Arch Cardiovasc Dis. 2017;110:14–25.CrossRef
27.
go back to reference Hagan PG, Nienaber CA, Isselbacher EM, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897–903.CrossRef Hagan PG, Nienaber CA, Isselbacher EM, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897–903.CrossRef
28.
go back to reference Endlich M, Hamiko M, Gestrich C, et al. Long-term outcome and quality of life in aortic type a dissection survivors. Thorac Cardiovasc Surg. 2016;64:91–9.PubMed Endlich M, Hamiko M, Gestrich C, et al. Long-term outcome and quality of life in aortic type a dissection survivors. Thorac Cardiovasc Surg. 2016;64:91–9.PubMed
29.
go back to reference Moritz A, Steinseifer U, Kobinia G, et al. Closing sounds and related complaints after heart valve replacement with St Jude Medical, Duromedics Edwards, Björk-Shiley Monostrut, and Carbomedics prostheses. Br Heart J. 1992;67:460–5.CrossRef Moritz A, Steinseifer U, Kobinia G, et al. Closing sounds and related complaints after heart valve replacement with St Jude Medical, Duromedics Edwards, Björk-Shiley Monostrut, and Carbomedics prostheses. Br Heart J. 1992;67:460–5.CrossRef
30.
go back to reference Noyez L, de Jager MJ, Markou AL. Quality of life after cardiac surgery: underresearched research. Interact Cardiovasc Thorac Surg. 2011;13:511–4.CrossRef Noyez L, de Jager MJ, Markou AL. Quality of life after cardiac surgery: underresearched research. Interact Cardiovasc Thorac Surg. 2011;13:511–4.CrossRef
Metadata
Title
Quality of life: modified triple-branched stent graft implantation versus frozen elephant trunk technique
Authors
Zeng-Rong Luo
Mi-Rong Tang
Jia-Hui Li
Liang-Wan Chen
Liang-Liang Yan
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-021-01683-9

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