[The surgical treatment for acute aortic dissection--a retrospective study from the statistics of affiliated hospitals of a medical school].
A retrospective study was conducted for the surgical treatment on acute aortic dissection among the cardiovascular services of 5 affiliated hospital of medical school. The total of 74 cases were operated for the last 5 years period from Jan., 1991 to Dec., 1995, in which 64 cases were classified as Type A and 10 for Type B. The average age for Type A was 58.4 years old and 10% of patients were consisted of Marfan syndrome. The most frequent complications associated with dissection was aortic regurgitation (37.5%), followed by cardiac tamponade (23.4%). The surgeries were undertaken in less than 24 hours from the onset of symptom in 45.3% of patients. The localization of initial tear as was proved by intraoperative finding was at ascending aorta in 64.0%, whereas it was found at aortic arch in 21.8% of patients. The most frequent application of operative procedure was simultaneous graft replacement of ascending aorta and aortic arch (68.7%) with the use of profound hypothermia and antegrade selective cerebral perfusion (85.4%). The overall mortality rate was 25.0%, however when compared as ascending only vs ascending + arch replacement, the later group demonstrated higher mortality rate (16.6% vs 28.9%). The majority of surgical indication for Type B was hemorrhage from the dissection and 20.0% of mortality was recorded in this group of patients.
Nakajima
N
N
First Department of Surgery, Chiba University School of Medicine, Japan.
Watanabe
H
H
Takahara
Y
Y
Uemura
S
S
Murayama
H
H
Takeuchi
S
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies