Midterm results of aortic arch replacement in a stanford type a aortic dissection with an intimal tear in the aortic arch.
OBJECTIVE
Stanford type A aortic dissection is a potentially catastrophic event that requires surgical repair, on an emergency basis. The extent of arch repair that should be carried out during emergency surgery of this type is controversial. This study was designed to evaluate the results of arch replacement carried out during acute type A dissection.


METHODS
28 patients with Stanford type A dissection and who underwent arch replacement between 1995 and 2006 were reviewed.


RESULTS
Hospital mortality was 3.6% (1 patient), and transient neurocognitive dysfunction was observed in 5 patients. During the follow-up period (mean 26+/-20 months; range 1 to 66 months), 3 patients underwent reoperation due to descending thoracic or abdominal aortic aneurysm. There was no late death. Follow up computed tomography was performed in 15 patients and false lumen disappeared totally or partially in 10 patients (66.7%).


CONCLUSIONS
Arch replacement for acute Stanford type A dissection may decrease the risk of late complications related to false lumen and lead to an excellent midterm survival rate.
Cho
Seong Ho
SH
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sung
Kiick
K
Park
Kay-Hyun
KH
Yang
Ji-Hyuk
JH
Kim
Wook Sung
WS
Jun
Tae-Gook
TG
Lee
Young Tak
YT
Park
Pyo Won
PW