Total and subtotal aortic replacement for extensive aortic dissection in patients with or without Marfan's syndrome.
OBJECTIVE
Extensive aortic dissection with multiple entries often found in Marfan's syndrome patients ultimately requires replacement of the whole aorta. We present a surgical strategy and results for total and subtotal aortic replacement.


METHODS
Subjects were 18 patients, including 14 Marfan's patients undergoing total (n = 13) or subtotal (excluding aortic arch) aortic replacement (n = 5), for DeBakey type I aortic dissection (n = 13) and DeBakey type IIIb aortic dissection with annuloaortic ectasia (n = 5) between February 1991 and April 2001. Mean age was 39.9 +/- 0.8 years--34.9 +/- 6.6 years in Marfan's patients vs. 57.7 +/- 4.7 years in non-Marfan patients. All operations were staged, with the mean number required per patient 3.1 +/- 0.8.


RESULTS
Early mortality was 0% and late mortality 11% (2 of 18). Paraplegia or paraparesis occurring in 11%. Except for these patients, all current survivors enjoy good quality of life.


CONCLUSIONS
Total and subtotal aortic replacement for extensive aortic dissection may decrease mortality due to rupture or associated disease.
Yamashita
Katsushi
K
First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
Kazui
Teruhisa
T
Terada
Hitoshi
H
Washiyama
Naoki
N
Suzuki
Takayasu
T
Ohkura
Kazuhiro
K
Doi
Hirosato
H
Okawa
Yohei
Y
Suzuki
Kazuchika
K
Ono
Takemi
T
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications*; D008875:Middle Aged