BACKGROUND: The aim of this study was to evaluate the effectiveness of our surgical strategy for acute aortic dissection based on the extent of the dissection and the site of the entry, with special emphasis on resection of all dissected aortic segments if technically possible. METHODS: Between January 1995 and March 2001, 43 consecutive patients underwent operations for acute aortic dissection. In all patients the distal repair was performed under circulatory arrest without the use of an aortic cross-clamp. Fifteen patients underwent aortic arch replacement with additional reconstruction of supra-aortic vessels in 3 patients. Complete replacement of all dissected tissue could be achieved in 21 patients (group 1). Because of the distal extent of the dissection beyond the aortic arch, replacement of all the dissected tissue was not possible in 22 patients (group 2). RESULTS: Early mortality was 4.7% (2 patients), and the incidence of perioperative cerebrovascular events was 7.0% (3 patients). All of these events occurred in group 2 (p < 0.025). During the follow-up period of 6 years or less, 5 patients died, all from causes not related to the aorta or the aortic valve. A persisting patent false lumen was observed in 14 of the 36 surviving patients (39%). CONCLUSIONS: Extended replacement of the dissected ascending aorta and aortic arch can be done with good early and midterm results, even though it requires a complex surgical technique. Therefore we advocate complete replacement of the dissected parts of the aorta in all patients in whom this is technically possible.
BACKGROUND: The aim of this study was to evaluate the effectiveness of our surgical strategy for acute aortic dissection based on the extent of the dissection and the site of the entry, with special emphasis on resection of all dissected aortic segments if technically possible. METHODS: Between January 1995 and March 2001, 43 consecutive patients underwent operations for acute aortic dissection. In all patients the distal repair was performed under circulatory arrest without the use of an aortic cross-clamp. Fifteen patients underwent aortic arch replacement with additional reconstruction of supra-aortic vessels in 3 patients. Complete replacement of all dissected tissue could be achieved in 21 patients (group 1). Because of the distal extent of the dissection beyond the aortic arch, replacement of all the dissected tissue was not possible in 22 patients (group 2). RESULTS: Early mortality was 4.7% (2 patients), and the incidence of perioperative cerebrovascular events was 7.0% (3 patients). All of these events occurred in group 2 (p < 0.025). During the follow-up period of 6 years or less, 5 patients died, all from causes not related to the aorta or the aortic valve. A persisting patent false lumen was observed in 14 of the 36 surviving patients (39%). CONCLUSIONS: Extended replacement of the dissected ascending aorta and aortic arch can be done with good early and midterm results, even though it requires a complex surgical technique. Therefore we advocate complete replacement of the dissected parts of the aorta in all patients in whom this is technically possible.
Authors: Jerry Easo; Ernst Weigang; Philipp P F Hölzl; Michael Horst; Isabell Hoffmann; Maria Blettner; Otto E Dapunt Journal: Ann Cardiothorac Surg Date: 2013-03
Authors: Antonio Lio; Francesca Nicolò; Emanuele Bovio; Andrea Serrao; Jacob Zeitani; Antonio Scafuri; Luigi Chiariello; Giovanni Ruvolo Journal: Tex Heart Inst J Date: 2016-12-01
Authors: Julia Merkle; Anton Sabashnikov; Antje-Christin Deppe; Mohamed Zeriouh; Johanna Maier; Carolyn Weber; Kaveh Eghbalzadeh; Georg Schlachtenberger; Olga Shostak; Ilija Djordjevic; Elmar Kuhn; Parwis B Rahmanian; Navid Madershahian; Christian Rustenbach; Oliver Liakopoulos; Yeong-Hoon Choi; Ferdinand Kuhn-Régnier; Thorsten Wahlers Journal: Ther Adv Cardiovasc Dis Date: 2018-10-08
Authors: Chang Hu Choi; Chul Hyun Park; Yang Bin Jeon; So Young Lee; Jae Ik Lee; Kook Yang Park Journal: Korean J Thorac Cardiovasc Surg Date: 2013-02-06