[Treatment of type A aortic dissection by exclusive gluing. Long-term results apropos of 15 patients].
Between 1984 and 1988, 15 patients with a type A aortic dissection were treated with direct suturing of the entry opening of the dissection and gluing of the dissected aortic layers using the GRF glue (gelatine-resorcine-formaldehyde), without prosthetic replacement. An associated aortic insufficiency, in 10 patients, was treated with valve replacement (5 patients) or plasty (5 patients). Deep hypothermia with circulatory arrest were necessary in 10 patients whose dissection reached the ascending aorta. All patients survived the procedure. These patients are followed from 6 to 44 months. They are all controlled by echo-Doppler. In addition, ten had an angiography, 6 a control scan and 5 a NMR. In twelve patients, the ascending aorta as well as the aortic junction are normal. A limited aortic dissection which did not require a secondary procedure, is found in 3 patients. A dissection of the descending aorta is present in 10 patients. Two patients had to be re-operated: one, for a valve replacement, 18 months later; the other, for a myocardiopathy at the terminal stage, 14 months later, requiring an orthotopic transplantation. These results show that gluing of the aorta is an easy and effective treatment in type A aortic dissections.
Fabiani
J N
JN
Département de Chirurgie Cardiovasculaire, Hôpital Broussais, Paris.
Jebara
V
V
Stephan
Y
Y
Couetil
J P
JP
Deloche
A
A
Bruneval
M
M
Carpentier
A
A
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000628:therapy*; D001014:Aortic Aneurysm / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use*
D014014:Tissue Adhesives
Traitement par encollage exclusif des dissections aortiques de type A. Résultats à long terme à propos de quinze patients.