A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'Can a "branch-first" approach to aortic arch replacement be safely utilized in Stanford type A acute aortic syndromes?' Altogether 64 papers were found using the reported searches, of which 10represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All papers included in this BET reported acceptable mortality and/or neurological outcomes in comparison to currently published standards for traditional repair. We conclude that while there is a need for larger series, direct comparison and long-term follow-up, the 'branch-first' approach to aortic arch replacement has been safely performed in several centres in the setting of acute aortic syndromes with results demonstrating acceptable mortality, neurological outcomes and mid-term survival.

中文翻译：

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“分支优先”的主动脉弓置换方法能否安全地用于斯坦福 A 型急性主动脉综合征？

心脏手术的最佳证据主题是根据结构化协议编写的。解决的问题是：“主动脉弓置换的‘分支优先’方法能否安全地用于斯坦福 A 型急性主动脉综合征？” 使用报告的检索总共找到了 64 篇论文，其中 10 篇代表了回答临床问题的最佳证据。这些论文的作者、期刊、出版日期和国家、研究的患者群体、研究类型、相关结果和结果均以表格形式列出。与当前发布的传统修复标准相比，该 BET 中包含的所有论文均报告了可接受的死亡率和/或神经学结果。我们的结论是，虽然需要更大规模的系列、直接比较和长期随访，但“分支优先”的主动脉弓置换方法已在多个中心在急性主动脉综合征的情况下安全地进行，结果表明可接受的死亡率、神经系统结果和中期生存率。