Comparison of Severe Complications after Acute Stanford Type B Aortic Dissection under Different Surgical Timing

Objective: To investigate the relationship between early intervention timing and complications of acute Stanford type B aortic dissection. Methods: The clinical data of 146 patients with acute stanford type B aortic dissection treated with transseptal stent for aortic endovascular repair (TEVAR) from January 2012 to October 2017 in Xiaogan Central Hospital were analyzed. The time was divided into 3 groups, including the onset to TEVAR time ≤ 48 h group (41 cases in group A), the onset to TEVAR time 48 h - 7 d group (56 cases in group B), the onset to TEVAR time 7 d - 14 d group (49 cases in group C)). The clinical baseline data, the incidence of different complications during perioperative period, and the mortality rate at 30 days were compared between the three groups. Results: There were no significant differences in age, gender and comorbidities between the three groups (all P > 0.05). Group A had a clearer indication of immediate intervention compared with group B and group C (P < 0.05). The overall incidence of severe complications in group C was significantly lower than that in group A and group B, and the difference was statistically significant (P < 0.05). There was no significant difference in reoperation rate and 30-day mortality between the 3 groups (all P > 0.05). Conclusion: Early intervention of acute TBAD may increase the risk of serious complications after surgery, and the incidence of serious complications will gradually decrease over time; the reduction of severe complications after early grouping is not accompanied by Early mortality and reoperation rates were significantly reduced, and TEVAR treatment in some patients with dissection did not prevent dissection progression and rupture.