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The surgical treatment for acute aortic dissection —A retrospective study from the statistics of affiliated hospital of a medical school—

  • Nobuyuki Nakajima
  • Hiroshi Watanabe
  • Yoshiharu Takahara
  • Shigeaki Uemura
  • Hirokazu Murayama
  • Shigeyasu Takeuchi
Original Article
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Abstract

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.

Keywords

Aortic Arch Aortic Dissection Aortic Regurgitation Cardiac Tamponade Circulatory Arrest 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 1998

Authors and Affiliations

  • Nobuyuki Nakajima
    • 2
    • 1
  • Hiroshi Watanabe
    • 2
    • 1
  • Yoshiharu Takahara
    • 3
    • 1
  • Shigeaki Uemura
    • 4
    • 1
  • Hirokazu Murayama
    • 5
    • 1
  • Shigeyasu Takeuchi
    • 6
    • 1
  1. 1.First Department of SurgeryChiba University School of MedicineChibaJapan
  2. 2.Matsudo City HospitalMatsudoJapan
  3. 3.Funabashi City Medical CenterFunabashiJapan
  4. 4.Chiba City Kaihin HospitalChibaJapan
  5. 5.Tsurumai Prefectural Hospital Cardiovascular CenterIchiharaJapan
  6. 6.Narita Red Cross HospitalNaritaJapan

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