The surgical treatment for acute aortic dissection —A retrospective study from the statistics of affiliated hospital of a medical school—
- 24 Downloads
A retrospective study was conducted for the surgical treatment on acute aortic dissection among the cardiovascular services of 5 affiliated hospital of a medical school. The total of 74 cases were operated for the last 5 yers period from Jan., 1991 to Dec, 1995, in which 64 cases were classified as Type A and 10 for Type B. The average age for Type A was 58.4 years old and 10% of patients were consisted of Marfan syndrome. The most frequent complications associated with dissection was aortic regurgitation (37.5%), followed by cardiac tamponade (23.4%). The surgeries were undertaken in less than 24 hours from the onset of symptom in 45.3% of patients. The localization of initial tear as was proved by intraoperative finding was at ascending aorta in 64.0%, whereas it was found at aortic arch in 21.8% of patients. The most frequent application of operative procedure was simultaneous graft replacement of ascending aorta and aortic arch (68.7%) with the use of profound hypothermia and antegrade selective cerebral perfusion (85.4%). The overall mortality rate was 25.0%, however when compared as ascending oly vs ascending + arch replacement, the later group demonstrated higher mortality rate (16.6% vs 28.9%). The majority of surgical indication for Type B was hemorrhage from the dissection and 20.0% of mortality was recorded in this group of patients.
KeywordsAortic Arch Aortic Dissection Aortic Regurgitation Cardiac Tamponade Circulatory Arrest
Unable to display preview. Download preview PDF.
- 2).Stanford A 39: 649–650, 1991Google Scholar
- 3).31: 383–386, 1991Google Scholar
- 5).Stanford 40: 2178–2181, 1992Google Scholar
- 6).DeBakey I 22: 480–483, 1993Google Scholar
- 7).2: 385–390, 1993Google Scholar
- 8).cerebroplegia 45: 556–562, 1997Google Scholar
- 10).44: 1082–1087, 1996Google Scholar
- 11).26 (Suppl): 172, 1997Google Scholar