title: [Is emergency aortic root replacement combined with arch replacement safe?].
abstract: BACKGROUND
  Aortic root replacement (ARR) combined with aortic arch replacement (AAR) is an invasive procedure even in elective cases. Nevertheless, such combined operations are often mandatory in acute type A aortic dissection. We examined whether emergency operation might have further incremental risks compared with elective surgery in this type of operations.
  
  
  METHODS
  Forty-six cases of ARR combined with AAR were divided into 2 groups, the emergency (EM) group and the elective (EL) group. The EM group consisted of 10 cases of acute type A aortic dissection, whereas the EL group of 36:23 of chronic aortic dissection and 13 of true aneurysm.
  
  
  RESULTS
  There were no statistical differences between the 2 groups in the durations of aortic crossclamp, selective cerebral perfusion and cardiopulmonary bypass. The incidences in the EM and EL groups were as follows:in-hospital death; 0 vs 3( 8%), respiratory failure; 4 (40%) vs 14 (39%), renal failure; 0 vs 6 (17%), IABP requirement; 1 (10%) vs 3 (8%), and cerebral infarction; 0 vs 1 (3%), respectively.
  
  
  CONCLUSIONS
  Early surgical results of emergency ARR combined with AAR were almost equal to those in elective surgery.
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kamada
authors.forename: S
authors.initials: S
authors.lastname: Kawamoto
authors.forename: N
authors.initials: N
authors.lastname: Motoyoshi
authors.forename: Y
authors.initials: Y
authors.lastname: Saiki
authors.forename: K
authors.initials: K
authors.lastname: Oda
authors.forename: J
authors.initials: J
authors.lastname: Akasaka
authors.forename: Y
authors.initials: Y
authors.lastname: Nitta
authors.forename: H
authors.initials: H
authors.lastname: Akimoto
authors.forename: K
authors.initials: K
authors.lastname: Tabayashi
mesh_terms: D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D017558:Elective Surgical Procedures; D004630:Emergencies; D006801:Humans