[Analysis of surgical treatment for Standford type A aortic dissection].
OBJECTIVE
To summarize the surgical experience of type A aortic dissection.


METHODS
From January 2001 to December 2006, 54 cases were admitted for Standford type A aortic dissection, including 36 cases of acute aortic dissection and 18 cases of chronic. Thirty-five cases underwent emergence operation and 11 cases underwent selective/limited operation, while 8 cases received medical treatment According to the modus operandi of root of aorta, 9 cases underwent ascending aorta replacement merely, 11 cases for Bentall operation, 12 cases for Wheat operation and ascending aorta replacement, 14 cases for David operation and ascending aorta replacement. According to the modus operandi of aortic arch and descendens, 6 cases underwent right hemiarch replacement, 25 cases for total arch replacement with four branches aortic graft, 24 cases for stent-graft elephant trunk technique. One patient of coronary heart disease and 1 patient of right coronary fracture underwent coronary artery bypass grafting. Deep hyperthermic circulatory arrest and antegrade selective cerebral perfusion were applied with aortic arch operation. Surface cooling was applied with selective/limited operation.


RESULTS
Four patients died in operation group (8.7%) and 8 died in non-operation group (75.0%). Postoperative complication included 1 mental symptom, 3 pleural/pericardial effusion, 1 hoarseness, 1 sternal rupture and poor wound healing. All the complication were cured. The operative out-hospital patients were followed up (13.0 +/- 14.2) months and the quality of life was satisfied.


CONCLUSIONS
Standford type A aortic dissection should be operated aggressively. Expected outcome could be acquired with optimum modus operandi, proper cerebral protection and dealing with postoperative complication timely.
Dai
Xiao-fu
XF
Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Chen
Liang-wan
LW
Chen
Dao-zhong
DZ
Lin
Feng
F
Wang
Qi-min
QM
Huang
Zhong-yao
ZY
Qiu
Han-fan
HF
Cao
Hua
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents