title: [Surgical treatment for acute type A aortic dissection; for better postoperative quality of life].
abstract: From November 1999 to December in 2005, 114 patients with acute type A aortic dissection underwent surgical treatment on an emergency basis. The overall in-hospital mortality was 7.9% (9 patients). Four were rupture cases before cardiopulmonary bypass. De novo postoperative stroke rate was 3.5% (4 patients). But all of them were discharged on foot. There were 6 rupture cases before operation. Unfortunately only 2 patients survived. Preoperative stroke due to malperfusion occurred in 19 cases (16.7%). Among them, those with clear consciousness had tendency to better social rehabilitation than those with drowsiness. We had experienced 2 vegetable states in the group of drowsiness after the operations. For better outcome, we must avoid rupture before operation and reconsider the timing of operation in the case of brain ischemia.
authors.affiliation: Department of Cardiovascular Surgery, Nara Hospital, Kinki University School of Medicine, Ikoma, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Kaneda
authors.forename: N
authors.initials: N
authors.lastname: Nishiwaki
authors.forename: H
authors.initials: H
authors.lastname: Nagato
authors.forename: S
authors.initials: S
authors.lastname: Hirao
authors.forename: D
authors.initials: D
authors.lastname: Heima
authors.forename: A
authors.initials: A
authors.lastname: Morishima
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001011:Aorta / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D014057:Tomography, X-Ray Computed