关键词: 急性A型主动脉夹层, 人工血管片, 改良三明治法

Abstract: Objective To observe the therapeutic effect of the "modified sandwich" technique with a prosthetic patch for aortic root reconstruction in surgery for acute type A aortic dissection. 
Methods A retrospective analysis was conducted on the clinical data of 48 patients with acute type A aortic dissection who underwent aortic root reconstruction using the "modified sandwich" technique with a prosthetic patch. The surgical procedures and postoperative outcomes were statistically analyzed. 
Results All 48 patients successfully underwent surgery. The median duration of cardiopulmonary bypass time was 196.5-307.5 min, and the median duration of aortic cross-clamp was 116.0-185.0 min. The median postoperative 24-h drainage volume was 308.8-845.0 mL. There were two perioperative deaths (4.167%), with causes attributed to renal failure with abdominal organ ischemia in one patient and coronary-related complications in the other. Postoperative complications included one patient (2.083%) undergoing re-exploration for hemostasis, which was unrelated to the vascular anastomosis, three patients (6.250%) requiring hemodialysis, one patient (2.083%) with paraplegia, and two patients (4.167%) with cerebral infarction and impaired left upper limb mobility. Additionally, one patient (2.083%) underwent tracheostomy, with a median mechanical ventilation duration of 48.0-121.0 h. Among the 46 recovered patients, pre-discharge follow-up with enhanced aortic CT revealed patent blood flow at the prosthetic vascular anastomosis site in all patients, except for one patient who exhibited residual dissection at the aortic sinus. 
Conclusion The "modified sandwich" technique using a prosthetic patch for aortic root reconstruction during surgery for acute type A aortic dissection is a straightforward and effective method, easy to grasp, and can reduce anastomotic seepage, prevent anastomotic dehiscence and bleeding. Therefore, it is worthy of clinical popularization. 

Key words: acute type a aortic dissection, prosthetic patch, modified sandwich technique