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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1508188
Article type: Original articles Application of Autologous Platelet Rich Plasma in Sun's Procedure for Acute Type A Aortic Dissection Under Moderate Hypothermia
Provisionally accepted- Qilu Hospital, Shandong University, Jinan, China
BackgroundCoagulopathy and inflammatory response are the intractable complication during Sun’s procedure for type A aortic dissection (AAD). This study aims to investigate the efficacy of autologous platelet rich plasma (aPRP) on the patients undergoing Sun’s procedure under moderate hypothermia.MethodsA total of 372 AAD patients who underwent Sun’s procedure under moderate hypothermia were divided into aPRP group (aPRP was separated before heparinization and transfused after protamine neutralization) and Non-aPRP group (without aPRP apheresis). Preoperative characteristics, intraoperative data, postoperative outcomes, and perioperative laboratory reports were collected and analyzed.ResultsThe operation time (301.1±21.3 vs 318.1±29.9, P<0.001), postoperative ventilation time (25.3[19.2, 37.0] vs 31.9[25.4, 43.1], P<0.001) and cardiac intensive care unit stay (4.8[3.5, 7.9] vs 8.7[4.9,11.2], P<0.001) in aPRP group were significantly shorter than that in Non-aPRP group. Intraoperative blood loss (637.2±24.9 vs 908.4±51.0, P<0.001), transfusion of allogeneic blood products (PLT: 2.11±1.03 vs 2.52±0.83, P<0.001; Plasma: 405.6±55.6 vs 421.0±61.7, P=0.012; Cryoprecipitate: 9.7±2.4 vs 10.4±1.9, P=0.002; RBC: 422.7±64.9 vs 479.2±81.0, P<0.001) and the incidence of postoperative pulmonary complications (8.2% vs 16.2%, P=0.027) were reduced in aPRP group. The costs of both blood products (9202.2±1597.4 vs 10031.9±3471.8, P=0.003) and the total hospitalization (243.5±33.1 vs 297.6±43.5, P<0.001) were decreased in aPRP group. Furthermore, intraoperative and postoperative levels of C-reactive protein and Interleukin-6 (P<0.001) in aPRP group were lower than that in Non-aPRP group. There was no significant difference in renal, cerebral complications and hospital stay between the two groups.ConclusionApplication of aPRP in Sun’s procedure reduced the perioperative blood loss and allogeneic blood transfusion, contributed to the decreased postoperative pulmonary complications and shortened intensive care unit duration. Apheresis and re-infusion of aPRP in Sun’s procedure alleviated postoperative inflammation to a certain degree and was a desirable approach for AAD patients.
Keywords: Acute type A aortic dissection, Sun's procedure, Autologous platelet rich plasma, Platelet Activation, coagulation, Inflammation
Received: 09 Oct 2024; Accepted: 30 Jan 2025.
Copyright: © 2025 Sun, Wei, Liu, Zhao and Liu. 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:
Kai Liu, Qilu Hospital, Shandong University, Jinan, China
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