Acute type A aortic dissection
Conditions
Interventions
Low heart rate group:The target heart rate is 55–65 bpm, achieved with physician-selected agents tailored to patient condition and institutional preference.
Standard heart rate group:The target heart rate is 75–85 bpm, achieved with physician-selected agents tailored to patient condition and institutional preference.
Sponsors
Fuwai Hospital, CAMS and PUMC
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Patients aged 18-80 years; 2. Acute aortic dissection (Stanford Type A) was diagnosed, excluding intramural hematoma of aorta, penetrating aortic ulcer, and aortic true aneurysm. The time from onset to screening was less than 1 week; 3. Ventricular rate > 75 beats/min at the study center; 4. Aortic arch replacement combined with the frozen elephant trunk implantation; 5. Informed consent has been signed.
Exclusion criteria
Exclusion criteria: 1. The patient's aortic dissection was classified as A3, that is, the aortic sinus was heavily involved, the sinus diameter was > 5 cm, or the sinotubular junction structure was damaged due to intimal tear; 2. Patients with sinus bradycardia or sick sinus syndrome or atrioventricular block of degree II or III, but without pacemaker; 3. Atrial fibrillation at the time of visiting hospital or screening; 4. More than moderate pericardial effusion, cardiogenic shock, systolic blood pressure less than 12 kPa (90 mmHg), heart rate less than 50 beats/min; 5. Patients with congestive heart failure or refractory cardiac insufficiency, or patients who had received cardiopulmonary resuscitation before enrollment; 6. Patients with aortic isthmus stenosis or arteriovenous shunt; 7. Bronchial asthma or a history of bronchial asthma or severe chronic obstructive pulmonary disease; 8. Pregnant or lactating women; 9. Patients with moderate to severe renal insufficiency; 10. Patients with severe liver insufficiency; 11. Patients with confirmed severe congenital heart disease or coronary heart disease requiring cardiac surgery other than aortic surgery; 12. Patients who are allergic to Esmolol injection, Diltiazem injection or Urapidil injection; 13. End-stage disease with an estimated survival of less than 2 years; 14. Patients with mental or legal disabilities; 15. The patient is participating in another interventional clinical study; 16. The clinicians or investigators consider that the patient has other conditions that are not suitable for admission to the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of major cardiovascular adverse events within 30 days after surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| All-cause mortality;Incidence of every major cardiovascular adverse events;Incidence of acute kidney injury in the first week after surgery;Total length of stay in the hospital;Postoperative hospital stay;Length of stay in ICU;Total hospitalization cost;cTnI or hs-cTnI;NT-proBNP; | — |
Countries
China
Contacts
Public ContactSu Yuan, Cuntao Yu
Fuwai Hospital, CAMS and PUMC
Outcome results
None listed