ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1622468
This article is part of the Research TopicAdvances in Diagnostics and Interventions For Acute Aortic Syndromes Involving The Aortic ArchView all articles
Efficacy of left subclavian artery laser in situ fenestration combined with hybrid arch debranching surgery for aortic arch reconstruction in patients with Stanford type A aortic dissection
Provisionally accepted
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Objective: To investigate the early and mid-term outcomes of in situ laser fenestration(ISLF) of the left subclavian artery (LSA) combined with hybrid aortic arch debranching for aortic arch reconstruction in Stanford type A aortic dissection. Methods: This retrospective study analyzed 57 patients (60+ years) treated from 2018-2023. LSA reconstruction-related complications were defined as: anastomotic bleeding, LSA occlusion, stent migration, or fenestration-related endoleak. Patients were divided into ISLF+debranching (n=29) and debranching-only (n=28) groups.Outcomes were compared using t-tests and Kaplan-Meier analysis.Results: The ISLF group had shorter operative time (323.1±10.3 vs 329.4±7.2 min, P=0.009) and higher LSA reconstruction success (100% vs 75%, P=0.013). LSA complication rates were lower in the ISLF group (3.4% vs 28.6%, P=0.025).Five-year survival was similar (79.3% vs 75.0%, P=0.575).ISLF with hybrid debranching improves LSA reconstruction success and reduces complications without affecting survival.
Keywords: dissecting aneurysm, aortic dissection, Thoracic aorta, Left subclavian artery, Debranching hybrid surgery, In situ laser fenestration
Received: 22 May 2025; Accepted: 14 Aug 2025.
Copyright: © 2025 Zhang, Zhao, Yue, Zhang, Sun, Xu, Liu, Hua and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhaohui Hua, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
Zhen Li, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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