Outcome of Surgical Treatment in Patients With Acute Type B Aortic Dissection
| Autor: | Kenu Fumimoto, Susumu Manabe, Kazutaka Horiuchi, Shuichiro Takanashi, Tomoki Shimokawa, Naomi Ozawa, Tetsuya Tobaru |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Aortic arch medicine.medical_specialty Time Factors Dissection (medical) Aortography Risk Assessment Severity of Illness Index Cohort Studies Blood Vessel Prosthesis Implantation Postoperative Complications medicine.artery medicine Humans Heart bypass Hospital Mortality Survival rate Aged Retrospective Studies Aortic dissection Aorta Aortic Aneurysm Thoracic business.industry Perioperative Middle Aged medicine.disease Blood Vessel Prosthesis Prosthesis Failure Surgery Survival Rate Aortic Dissection Treatment Outcome Anesthesia Descending aorta Acute Disease Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 86:103-107 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2008.02.098 |
| Popis: | Background Surgery for acute type B aortic dissection is associated with significant mortality and morbidity. The purpose of this study was to assess the clinical outcome of surgical management of complicated acute type B aortic dissection. Methods During the last 5 years, 112 patients were admitted for acute type B aortic dissection. Of these patients, 24 consecutive patients were enrolled who underwent surgical management during the acute or subacute stage. The mean age was 66.7 ± 9.1 years; 8 patients were female. Indications for surgery were rupture in 10 patients, impending rupture in 7, and malperfusion in 7. Fifteen patients were transferred from another hospital. The overall clinical outcome including morbidity, aorta-related events, and death were retrospectively assessed. Results The mean duration from the time of onset to surgery was 7.1 ± 9.0 days. Graft replacement of the aorta included the total aortic arch with cerebral perfusion in 6 patients, and replacement of the distal aortic arch or descending aorta with left heart bypass in 12. The remaining 6 patients underwent peripheral bypass for ischemia. Significant complications occurred in 7 patients (24.8%). The operative mortality rate was 8.3% (2 of 24); 5.6% (1 of 18) with central operation and 16.7% (1 of 6) with peripheral operation. The 5-year survival rate was 82.6 ± 7.9% and freedom from aorta-related events at 1 and 5 years were 95.2% ± 4.7% and 68.0% ± 16.6%, respectively. Conclusions Surgical management of patients with complicated acute type B dissection has an acceptable perioperative risk and survival. This study suggests earlier surgery with left heart bypass may be beneficial for appropriate patients. |
| Databáze: | OpenAIRE |
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