title: [Early and Mid-term Outcomes of Surgical Treatment with Conservative Approach Using Adventitial Inversion Technique for an Acute Type A Aortic Dissection].
abstract: OBJECTIVE
  This study was performed to assess the early and mid-term outcomes of surgical treatment with adventitial inversion technique for an acute type A aortic dissection.
  
  
  METHODS
  From June 2008 to June 2015, 48 patients underwent emergent surgery for acute type A aortic dissection. Ascending aorta/hemiarch replacement was performed in 44/48(91.7%)patients, and total arch replacement in 4/48(8.3%)patients. The adventitial inversion technique was used for both proximal and distal stump constructions of the dissected aortic wall without the reinforcement of Teflon felt. Aortic regurgitation was treated with resuspention of aortic commissures.
  
  
  RESULTS
  The operative mortality was 8.3%(4/48). There was no re-exploration in all patients. Postoperative computed tomography showed the obliteration of false lumen in aortic root in all of patients, and aortic arch and/or descending thoracic aorta in 80.9%(38/47)of patients. The actuarial survival rates at 5 years were 74.7%.The freedom from aortic or aortic valve event rate and reoperation rate at 5 year were 90.9% and 95.2%, respectively.
  
  
  CONCLUSIONS
  The adventitial inversion technique provides excellent early and mid-term outcomes for the repair of acute type A aortic dissection.
authors.affiliation: Department of Cardiovascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Takane
authors.initials: T
authors.lastname: Hiraiwa
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D008297:Male; D013536:Suture Techniques; D016896:Treatment Outcome