Type A acute aortic dissection: Immediate and mid-term results of emergency aortic replacement with the aid of gelatin resorcin formalin glue

2004 ◽  
Vol 78 (3) ◽  
pp. 853-857 ◽  
Author(s):  
Mitsumasa Hata ◽  
Motomi Shiono ◽  
Akira Sezai ◽  
Mitsuru Iida ◽  
Nanao Negishi ◽  
...  
2020 ◽  
Author(s):  
Wei Qin ◽  
Cunhua Su ◽  
Liangpeng Li ◽  
Michael Carmichael ◽  
Fuahua Huang ◽  
...  

Abstract Objective This study compared limited aortic repair (ascending, and /or hemi-arch replacement) versus extended-arch repair (ascending, arch and proximal descending aortic replacement) used for patients aged 65 or older, who had type A acute aortic dissection (AAD), analyzing the influence of the extent of aortic repair on outcomes. Methods From January, 2001 to December, 2015, 103 patients aged 65 or older underwent operation due to type A AAD in Nanjing First Hospital. The cohort was divided into two subgroups according to the surgical approaches, including limited aortic replacement (LAR, n = 41) and total arch replacement + stent elephant trunk implantation (TAR + SET, n = 62). Results There was no significant difference in gender, age, hypertension, diabetes, smoking, PCI history, atrial fibrillation, pericardial effusion, aortic valve insufficiency (≥ moderate), shock situation before operation, and Euro-score II between the two groups except limb malperfusion and tear location. The cross-clamp time, CPB time, intubation time, ICU stay time and hospital time were all significantly less in the LAR group than in the TAR + SET group. A total of 89 patients were discharged home successfully after operation, with a difference of hospital mortality (P = 0.04). The overall survival rates at 5-year follow-up were 82.5 ± 6.0% in LAR group and 75.2 ± 5.6% in TAR + SET group, but with no difference (p = 0.151). The freedom from adverse aortic events at 5-year was 84.3 ± 6.5% in LAR group versus 97.9 ± 2.1% in TAR + SET group, with a statistical difference (p = 0.03). Conclusion These findings support limited aortic resection is acceptable for elderly patients with type A AAD if surgical principles allow.


2020 ◽  

Acute aortic dissection type A with subtotal or total occlusion of one carotid artery is a complex situation. An additional extra-anatomic carotid artery bypass can restore carotid artery perfusion after standard emergency surgery with aortic replacement.


2020 ◽  
Author(s):  
Wei Qin ◽  
Cunhua Su ◽  
Liangpeng Li ◽  
Michael Carmichael ◽  
Fuahua Huang ◽  
...  

Abstract Background: This study compared limited aortic repair (ascending, and /or hemi-arch replacement) versus extended-arch repair (ascending, arch and proximal descending aortic replacement) used for patients aged 65 or older, who had type A acute aortic dissection (AAD), analyzing the influence of the extent of aortic repair on outcomes.Methods: From January, 2001 to December, 2015, 103 patients aged 65 or older underwent operation due to type A AAD in Nanjing First Hospital. The cohort was divided into two subgroups according to the surgical approaches, including limited aortic replacement (LAR, n=41) and total arch replacement + stent elephant trunk implantation (TAR+SET, n=62). Results: There was no significant difference in gender, age, hypertension, diabetes, smoking, PCI history, atrial fibrillation, pericardial effusion, aortic valve insufficiency (≥ moderate), shock situation before operation, and Euro-score II between the two groups except limb malperfusion and tear location. The cross-clamp time, CPB time, intubation time, ICU stay time and hospital time were all significantly less in the LAR group than in the TAR+SET group. A total of 89 patients were discharged home successfully after operation, with a difference of hospital mortality (P=0.04). The overall survival rates at 5-year follow-up were 82.5±6.0% in LAR group and 75.2±5.6% in TAR+SET group, but with no difference (p=0.151). The freedom from adverse aortic events at 5-year was 84.3±6.5% in LAR group versus 97.9±2.1% in TAR+SET group, with a statistical difference (p=0.03). Conclusion: These findings support limited aortic resection is acceptable for elderly patients with type A AAD if surgical principles allow.


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