title: Total and subtotal aortic replacement for extensive aortic dissection in patients with or without Marfan's syndrome.
abstract: 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.
authors.affiliation: First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Kazui
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Terada
authors.forename: Naoki
authors.initials: N
authors.lastname: Washiyama
authors.forename: Takayasu
authors.initials: T
authors.lastname: Suzuki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ohkura
authors.forename: Hirosato
authors.initials: H
authors.lastname: Doi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Okawa
authors.forename: Kazuchika
authors.initials: K
authors.lastname: Suzuki
authors.forename: Takemi
authors.initials: T
authors.lastname: Ono
mesh_terms: 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