OC51 NEW TECHNIQUE IN TYPE I ACUTE AORTIC DISSECTION FOR ARCH STABILIZATION AND FUTURE LANDING ZONE CREATION WITHOUT ARCH REPLACEMENT

2018 ◽  
Vol 19 ◽  
pp. e3
Author(s):  
P. Masiello ◽  
A. Longobardi ◽  
A. Panza ◽  
G. Mastrogiovanni ◽  
F. Cafarelli ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
New Technique ◽  
Type I ◽  
Landing Zone

scholarly journals Surgical Treatment of Acute Type A Aortic Dissection with 18-Litre Bleeding

Aorta ◽  
2021 ◽  
Vol 09 (01) ◽  
pp. 030-032
Author(s):  
Sergey Y. Boldyrev ◽  
Kirill O. Barbukhatty ◽  
Vladimir A. Porhanov
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Type I ◽  
Acute Type ◽  
Drug Induced ◽  
Type A Aortic Dissection ◽  
Mortality And Morbidity ◽  
Perioperative Bleeding

AbstractSurgical treatment of Type-A acute aortic dissection is associated with high mortality and morbidity. One of the reasons is perioperative bleeding, which may lead to worse outcomes. We present a case of successful treatment of a patient with 18-litre perioperative blood loss in DeBakey Type-I acute aortic dissection with drug-induced hypocoagulation and malperfusion of a lower extremity.

scholarly journals Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chun-Yu Lin ◽  
Tao-Hsin Tung ◽  
Meng-Yu Wu ◽  
Chi-Nan Tseng ◽  
Feng-Chun Tsai
Keyword(s):  
Propensity Score ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Acute Aortic Dissection ◽  
Survival Rates ◽  
Type I ◽  
Acute Type ◽  
Type Ii ◽  
Matched Cohort ◽  
Reoperation Rates

Abstract Background The DeBakey classification divides Stanford acute type A aortic dissection (ATAAD) into DeBakey type I (D1) and type II (D2) according to the extent of acute aortic dissection (AAD). This retrospective study aimed to compare the early and late outcomes of D1-AAD and D2-AAD through a propensity score-matched analysis. Methods Between January 2009 and April 2020, 599 consecutive patients underwent ATAAD repair at our institution, and were dichotomized into D1 (n = 543; 90.7%) and D2 (n = 56; 9.3%) groups. Propensity scoring was performed with a 1:1 ratio, resulting in a matched cohort of 56 patients per group. The clinical features, postoperative complications, 5-year cumulative survival and freedom from reoperation rates were compared. Results In the overall cohort, the D1 group had a lower rate of preoperative shock and more aortic arch replacement with longer cardiopulmonary bypass time. The D1 group had a higher in-hospital mortality rate than the D2 group in overall (15.8% vs 5.4%; P = 0.036) and matched cohorts (19.6% vs 5.4%; P = 0.022). For patients that survived to discharge, the D1 and D2 groups demonstrated similar 5-year survival rates in overall (77.0% vs 85.2%; P = 0.378) and matched cohorts (79.1% vs 85.2%; P = 0.425). The 5-year freedom from reoperation rates for D1 and D2 groups were 80.0% and 97.1% in overall cohort (P = 0.011), and 93.6% and 97.1% in matched cohort (P = 0.474), respectively. Conclusions Patients with D1-AAD had a higher risk of in-hospital mortality than those with D2-AAD. However, for patients who survived to discharge, the 5-year survival rates were comparable between both groups.

scholarly journals Early Spontaneous Resolution of an Iatrogenic Acute Type A Aortic Dissection

Aorta ◽  
2016 ◽  
Vol 04 (06) ◽  
pp. 235-239
Author(s):  
Mohammad Zafar ◽  
Philip Pang ◽  
Glen Henry ◽  
Bulat Ziganshin ◽  
Maryann Tranquilli ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Type I ◽  
Acute Type ◽  
Computed Tomography Scan ◽  
Descending Aorta ◽  
Type A Aortic Dissection ◽  
Tomography Scan

AbstractAcute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month.

scholarly journals Bentall surgery for acute aortic dissection (type-a) in a patient with marfan syndrome

KYAMC Journal ◽  
2018 ◽  
Vol 9 (2) ◽  
pp. 95-100
Author(s):  
Mohammad Arifur Rahman ◽  
Md Lutfar Rahman ◽  
Prakash Chandra Munshi ◽  
Taslim Yusuf Tamal ◽  
Mejbaur Rahman ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Acute Aortic Dissection ◽  
Axillary Artery ◽  
Clinical Manifestations ◽  
Type A ◽  
Moderate Hypothermia ◽  
Type I ◽  
Acute Type ◽  
Aortic Dissection Type A

Background: Marfan syndrome is an autosomal-dominant hereditary connective tissue disorder with the clinical manifestations involving the ocular, skeletal, and cardiovascular systems. The cardiovascular manifestations include aortic root dilatation, aortic valvular insufficiency, mitral valve prolapse, mitral regurgitation, aortic dissection and aortic rupture. Acute aortic dissection is one of the most common catastrophes involving the aorta. A high index of suspicion is important in patients who have predisposing risk factors. Classification is based on the location of dissection and its duration. Stanford type A (De bakey type I /type II) dissection should be treated surgically in essentially all cases.Objective: To report our experience in Bentall surgery in Acute aortic dissection (type A ). The efficacy of right axillary artery cannulation was investigated.Materials & Methods: Patient with acute type A aortic dissection involving coronary sinuses with 3 vessels of the arch free of lesions underwent aortic valve with ascending aorta and hemiarch replacement with composite valve graft (Bentall procedure) and reimplantation of coronary arteries under moderate hypothermia. The axillary artery was used for arterial cannulation.Results: Weaning from CPB was smooth. Perioperative period was eventless. Follow-up Echo revealed normal cardiac parameters.Conclusion: Prompt establishment of the diagnosis, through focused physical examination and noninvasive imaging, followed by rapid medical and surgical therapy, are the only effective methods to alter survival in patients with acute aortic dissection.KYAMC Journal Vol. 9, No.-2, July 2018, Page 95-100

Abstract 13504: Timely Recognition and Successful Clinical Outcome of an Acute Debakey Type I Aortic Dissection

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Dakshin Gangadharamurthy ◽  
Muhammad M Furqan ◽  
Allan L Klein ◽  
Saurabh Malhotra ◽  
Rachel Harrison ◽  
...  
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Aortic Regurgitation ◽  
Aortic Root ◽  
Acute Aortic Dissection ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Facility ◽  
Type I ◽  
Malperfusion Syndrome

Background: Acute Aortic dissection is a critical etiology of chest pain with very high mortality. 1% to 2% of patients die per hour during the initial 24 to 48 hours. Case: A 62 year old lady with history of diabetes, hypertension, hyperlipidemia, hypothyroidism, smoking and no pertinent family history presented with atypical chest pain. She remained hemodynamically stable with no discrepancy of BP between arms. Labs: troponin 0.64, 0.63 ng/ml. EKG: sinus bradycardia. Chest x-ray: no mediastinal widening or signs of aortic aneurysm. Coronary angiogram showed 20-30 % stenosis in left anterior descending and right coronary arteries. An aortogram showed dilated aortic root over 6 cm with aortic regurgitation. Decision-making: An emergent echocardiogram confirmed acute aortic regurgitation and dissection. CT angiogram showed DeBakey type I aortic dissection extending from aortic annulus to infra renal aorta, supra aortic great vessels, celiac axis and left renal artery. She had no signs of malperfusion syndrome. She was started on iv Esmolol and emergently airlifted to tertiary care facility for surgical repair. Intra operative TEE showed findings consistent with acute aortic dissection. She had successful modified Bentall procedure with replacement of aortic valve, aortic root, ascending aorta and hemi arch. She had excellent recovery and continues to do well at follow up visits in our clinic. Conclusion: An early diagnosis of acute aortic dissection requires high index of suspicion due to variable symptoms and clinical manifestations. DeBakey type I aortic dissection may have better chance of survival in the absence of malperfusion syndrome if treated early as in this case.

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