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find Keyword " Aortic surgery" 1 results
  • Surgical Treatment for Acute Aortic Dissection with Involvement of Aortic Root

    Abstract: Objective To evaluate surgical strategies for the treatment of acute Stanford type A aortic dissection with involvement of the aortic root. Methods From January 2005 to December 2010, 62 consecutive patients underwent emergency surgical intervention for acute Stanford type A aortic dissection with involvement of the aortic root in Renji Hospital Affiliated to Medical School of Shanghai Jiaotong University. According to different methods for the management of proximal aortic dissection, these patients were divided into 3 groups: group A, aortic valve commissural suspension+supracommissural replacement of the ascending aorta (SCR),including 28 patients (20 males and 8 females,mean age 45.2±15.6 years); group B, partial sinus remodeling+ascending aortic replacement, including 10 patients (7 males and 3 females,mean age 44.6±14.9 years);group C, Bentall procedure,including 24 patients (17 males and 7 females,mean age 46.2±15.6 years). Clinical outcomes were compared among the three groups. Results Six patients died peri-operatively and in-hospital mortality was 9.67% (6/62). Fifty-four patients were followed up, and the mean follow-up time was 27.3±15.7 months. During follow up, 2 patients died, one for lung cancer and the other for unknown reason. One patient in group A underwent CT scan 6 months after surgery which showed aortic root pseudo-aneurysm. Cardiopulmonary bypass time and aortic cross-clamping time of group C were significantly longer than those of group A and group B (274±97 min vs. 194±65 min, 210±77 min, t=22.482, 30.419, P=0.002, 0.122;150±56 min vs. 97±33 min, 105±46 min, t=12.630, 17.089, P=0.000,0.034). There was no statistical difference in mortality (t=1.352,P=0.516), incidence of postoperative reexploration for bleeding, acute renal failure and neurological complication (t=0.855, 0.342, 2.281; P=0.652, 0.863, 0.320) among the three groups. Conclusion For patients with acute aortic dissection involving the aortic root, aortic valve commissural suspension+SCR,partial sinus remodeling+ascending aortic replacement and Bentall procedure may be considered the surgical treatment of choice with respective advantages and disadvantages. Satisfactory clinical outcomes can be achieveed if surgical indications and procedures are properly employed.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
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