title: Midterm results of aortic repair using a fabric neomedia and fibrin glue for type A acute aortic dissection.
abstract: BACKGROUND
  Controversy exists concerning the optimal surgical treatment of acute type A aortic dissection to reduce mortality rate and the need for reoperation. The goal of the present study was to evaluate midterm results of repair using a fabric and fibrin glue for acute type A aortic dissection.
  
  
  METHODS
  From 1994 to 2005, 100 patients with acute type A aortic dissection underwent supracommissural graft replacement using a fabric as "neomedia" and fibrin glue. Mean patient age was 65.7 +/- 11.3 years.
  
  
  RESULTS
  Hospital mortality was 9%. All 91 survivors underwent follow-up evaluation for a mean period of 47.7 months. Aortic regurgitation was restored to non or mild in 46 survivors who had preoperative aortic regurgitation in the immediate period, and only one patient developed moderate aortic regurgitation in the midterm period. Survival at 1, 5, and 10 years including hospital mortality was 89.0 +/- 3.1%, 75.2 +/- 5.1%, and 59.2 +/- 10.9%, respectively. Reoperation for aortic lesion was performed without mortality in three patients (residual dissection, n = 1; sinus of Valsalva dilatation, n = 1; acute redissection, n = 1). During two late reoperations, the fabric was observed to be firmly adherent to the dissected wall and maintained the shape of the aorta. Freedom from aortic reoperation was 98 +/- 2% and 98 +/- 2%, at 5 and 10 years, respectively.
  
  
  CONCLUSIONS
  Supracommissural aortic replacement using a fabric neomedia and fibrin glue resulted in low early and late mortality as well as a low reoperation rate.
authors.affiliation: Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Iwate Medical University, Morioka, Japan. t_nakajima@imu.ncvc.go.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakajima
authors.forename: Kohei
authors.initials: K
authors.lastname: Kawazoe
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kataoka
authors.forename: Hajime
authors.initials: H
authors.lastname: Kin
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Kazui
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Okabayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Niinuma
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013526:Surgical Mesh; D014014:Tissue Adhesives / Q000627:therapeutic use*; D017540:Tunica Media
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives