Is Cabrol fistula techniques really justified in surgical of aortic disease?

Abstract

Abstract Objective: Cabrol fistulas are often used as a bailout procedure in cases of reoperation and severe calcifications in complex aneurysm surgery. However, the justification for using Cabrol fistulas in aortic dissection has been controversial. This study retrospectively evaluated the clinical outcomes of the prophylactic use of Cabrol fistulas. Methods: The design of this study was a retrospective study. We queried 414 patients with aortic aneurysms or type A aortic dissection who underwent emergency or selective aortic surgery at our center from January 2015 to December 2020 and were followed up until 2022. Among them, 280 patients were treated with the Cabrol fistula (Cabrol group), and 134 patients did not receive this technique (non-Cabrol group). The clinical data of all patients were retrospectively analyzed and followed up. Results: The 30-day mortality rate of the Cabrol group was higher than that of the non-Cabrol group (n = 29, 10.36% vs n = 7, 5.22%, p < 0.001). The Cabrol group had a lower drainage volume 3 days after surgery (1241 [IQR, 939-1638.5 ml] vs 1480 [IQR, 1245-1725 ml]). There were no significant differences in postoperative complications, BNP levels, CCU stay time, ventilation time, or reoperation (p > 0.05). These outcomes did not appear to differ in subgroup analysis for patients between the two groups. Conclusions: This study provides evidence that Cabrol fistulas can reduce postoperative drainage. However, patients who underwent Cabrol fistulas had increased 30-day mortality. The Cabrol technique can be used as an emergency measure for aortic surgical bleeding but cannot be used as a routine method.