OBJECTIVE: This study aimed to evaluate the outcomes of repeat interventions on the aorta and aortic valve after surgery for acute Stanford type A aortic dissection. METHODS: The hospital records of patients who underwent repeat surgical intervention between April 2011 and March 2017 for late complications after acute type A aortic dissection repair were retrospectively reviewed. RESULTS: We identified 17 patients with mean age of 62 ± 8 years; 13 were men. The mean interval from the initial emergency aortic repair to the repeat intervention was 5.8 ± 5.4 years (range 133 days-16.6 years). Ten patients had dilatation or rupture of the residual type B aortic dissection; six of them had retrograde type A aortic dissection at the onset and did not undergo resection of the primary entry. Five patients had a pseudoaneurysm at the anastomosis; four of them were receiving anticoagulation medication. Three patients had aortic regurgitation; two of them were associated with the gelatin-resorcinol-formaldehyde glue that was used during the initial surgery. There was no early mortality after repeat intervention and no late death after a mean follow-up period of 3.3 ± 2.0 years. CONCLUSIONS: Repeat surgical intervention on the aorta and aortic valve after repair of acute type A aortic dissection had favorable early and mid-term outcomes and was not associated with early or late death. Long-term follow-up with imaging and echocardiography was considered to be essential for early detection of residual type B dilatation, anastomotic pseudoaneurysm, and aortic regurgitation after initial aortic repair.
OBJECTIVE: This study aimed to evaluate the outcomes of repeat interventions on the aorta and aortic valve after surgery for acute Stanford type A aortic dissection. METHODS: The hospital records of patients who underwent repeat surgical intervention between April 2011 and March 2017 for late complications after acute type A aortic dissection repair were retrospectively reviewed. RESULTS: We identified 17 patients with mean age of 62 ± 8 years; 13 were men. The mean interval from the initial emergency aortic repair to the repeat intervention was 5.8 ± 5.4 years (range 133 days-16.6 years). Ten patients had dilatation or rupture of the residual type B aortic dissection; six of them had retrograde type A aortic dissection at the onset and did not undergo resection of the primary entry. Five patients had a pseudoaneurysm at the anastomosis; four of them were receiving anticoagulation medication. Three patients had aortic regurgitation; two of them were associated with the gelatin-resorcinol-formaldehyde glue that was used during the initial surgery. There was no early mortality after repeat intervention and no late death after a mean follow-up period of 3.3 ± 2.0 years. CONCLUSIONS: Repeat surgical intervention on the aorta and aortic valve after repair of acute type A aortic dissection had favorable early and mid-term outcomes and was not associated with early or late death. Long-term follow-up with imaging and echocardiography was considered to be essential for early detection of residual type B dilatation, anastomotic pseudoaneurysm, and aortic regurgitation after initial aortic repair.
Authors: J A Bingley; M A Gardner; E G Stafford; T K Mau; P G Pohlner; R K Tam; H Jalali; P J Tesar; M F O'Brien Journal: Ann Thorac Surg Date: 2000-06 Impact factor: 4.330
Authors: Magnus Larsen; Santi Trimarchi; Himanshu J Patel; Marco Di Eusanio; Kevin L Greason; Mark D Peterson; Rossella Fattori; Stuart Hutchison; Nimesh D Desai; Amit Korach; Daniel G Montgomery; Eric M Isselbacher; Christoph A Nienaber; Kim A Eagle; Kristian Bartnes; Truls Myrmel Journal: Eur J Cardiothorac Surg Date: 2017-12-01 Impact factor: 4.191
Authors: Eric E Roselli; Jay J Idrees; Faisal G Bakaeen; Michael Z Tong; Edward G Soltesz; Stephanie Mick; Douglas R Johnston; Mathew J Eagleton; Venu Menon; Lars G Svensson Journal: Ann Thorac Surg Date: 2017-12-06 Impact factor: 4.330