scholarly journals Adventitial inversion in the distal anastomosis in surgical treatment of acute DeBakey type I aortic dissection

2016 ◽  
Vol 151 (5) ◽  
pp. 1346-1347
Author(s):  
Tirone E. David
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Distal Anastomosis ◽  
Type I

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year

scholarly journals Surgical Treatment of Acute Type A Aortic Dissection with 18-Litre Bleeding

Aorta ◽  
2021 ◽  
Vol 09 (01) ◽  
pp. 030-032
Author(s):  
Sergey Y. Boldyrev ◽  
Kirill O. Barbukhatty ◽  
Vladimir A. Porhanov
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Type I ◽  
Acute Type ◽  
Drug Induced ◽  
Type A Aortic Dissection ◽  
Mortality And Morbidity ◽  
Perioperative Bleeding

AbstractSurgical treatment of Type-A acute aortic dissection is associated with high mortality and morbidity. One of the reasons is perioperative bleeding, which may lead to worse outcomes. We present a case of successful treatment of a patient with 18-litre perioperative blood loss in DeBakey Type-I acute aortic dissection with drug-induced hypocoagulation and malperfusion of a lower extremity.

Results of Immediate Surgical Treatment of All Acute Type A Dissections

Circulation ◽  
2000 ◽  
Vol 102 (suppl_3) ◽  
Author(s):  
Marek P. Ehrlich ◽  
M. Arisan Ergin ◽  
Jock N. McCullough ◽  
Steven L. Lansman ◽  
Jan D. Galla ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Aortic Dissection ◽  
Type A ◽  
Distal Anastomosis ◽  
Hospital Death ◽  
Acute Type ◽  
Descending Aorta ◽  
Type A Aortic Dissection ◽  
Intimal Tear

Background —Surgery for acute type A aortic dissection is associated with a high mortality rate and incidence of postoperative complications. This study was designed to explore perioperative risk factors for death in patients with acute type A aortic dissection. Methods and Results —One hundred twenty-four consecutive patients with acute type A aortic dissection between 1984 and 1998 were reviewed. All underwent operation with resection of the intimal tear and open distal anastomosis: 107 patients had surgery within 24 hours and 17 patients had surgery within 72 hours of symptom onset. Median age was 62 years (23 to 89); 89 were men. Forty-three patients had ascending aortic replacement only, 72 had hemiarch repair, in 2 the entire arch was replaced, and in 7 replacement included the proximal descending aorta. The aortic valve was replaced in 54 patients, resuspended in 52, and untouched in 18. Hospital mortality rate was 15.3% (19 of 124): of these, 3 patients died during surgery, 4 had fatal rupture of the distal aorta before discharge, and 2 died of malperfusion-related complications. Multivariate analysis revealed age >60, hemodynamic compromise, and absence of hypertension as preoperative indicators of hospital death ( P <0.05); the presence of new neurological symptoms was a significant preoperative risk factor in univariate analysis. Ominous intraoperative factors included contained hematoma and a comparatively low esophageal temperature but not cerebral ischemic time (mean 32 minutes). The site of the intimal tear did not influence outcome, but mortality rate was higher with more extensive resection: 43% with resection including the descending aorta died versus 14% with only ascending aorta or hemiarch replacement. Overall 5- and 10-year survival was 71% and 54%, respectively; among discharged patients (median follow-up 41 months) survival was 84% and 64% versus expected US survival of 92% and 79%. Conclusions —Immediate surgical treatment of all acute type A dissections with resection of the intimal tear and use of hypothermic circulatory arrest for distal anastomosis results in acceptable early mortality rates and excellent long-term survival.

scholarly journals DeBakey type I acute aortic dissection with circular separation of the intima of the brachiocephalic trunk

2021 ◽  
Vol 180 (4) ◽  
pp. 78-81
Author(s):  
S. Yu. Boldyrev ◽  
V. N. Suslova ◽  
V. A. Pekhterev ◽  
K. O. Barbukhatti ◽  
V. A. Porkhanov
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Clinical Case ◽  
Acute Aortic Dissection ◽  
Complete Separation ◽  
Type I ◽  
Brachiocephalic Trunk ◽  
Surgical Tactics ◽  
Ischemic Attack ◽  
Brachiocephalic Arteries

Surgical treatment of DeBakey type I acute aortic dissection is still accompanied by a relatively high mortality rate and complications. Organ malperfusion makes a serious contribution to the structure of mortality in the surgical treatment of patients with acute aortic dissection. At the same time, the spread of dissection to the brachiocephalic arteries is observed in 15–40 % of cases. Some of these patients suffer a transient ischemic attack or stroke in the preoperative period, which significantly aggravates the patient’s condition. We present a clinical case of successful surgical treatment of a patient with DeBakey type I acute aortic dissection, in whom intraoperatively a circular separation of intima from the mouth of the brachiocephalic trunk with its invagination into the lumen of the aortic arch was detected. The patient underwent supracoronary prosthetics of the ascending aorta with incomplete prosthetics of the entire arch and prosthetics of the brachiocephalic trunk. This clinical case demonstrates a variant of the natural course of DeBakey type I acute aortic dissection with a complete separation of intima, which requires active surgical tactics. Currently, due to the lack of sufficient clinical experience in the treatment of patients with such a diagnosis, the question of choosing the optimal surgical tactics remains open.

scholarly journals Hybrid technology in the surgical treatment of proximal aortic dissection

2018 ◽  
pp. 8-13
Author(s):  
A. M. Chernyavsky ◽  
M. M. Lyashenko ◽  
D. A. Syrota ◽  
D. S. Khvan ◽  
B. N. Kozlov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Medical Center ◽  
Surgical Approaches ◽  
Type I ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Mortality And Morbidity ◽  
Hybrid Technology ◽  
Perioperative Risks

Aim. To assess results of Meshalkin National Research Medical Center and Tomsk National Research Medical Center in surgical treatment of DeBakey type I aortic dissection using hybrid technologies (“frozen elephant trunk”) compared with classical standard interventions.Material and methods. The study included patients operated on successively in the 2002­2010 timeframe with a diagnosis of acute and subacute DeBakey type I aortic dissection. A retrospective observational comparison of the surgical treatment results of patients (two groups) was performed: using standard surgical approaches (beveled anastomosis or aortic arch replacement using multi­branched prosthesis) and frozen elephant trunk (FET) intervention. The groups included 70 and 31 patients, respectively. Mortality and morbidity were evaluated in the postoperative period, the frequency of aorto­related events — during the observation period.Results. Mortality and the frequency of complications between the groups in the early and late postoperative periods did not differ. Aorto­related events of the groups in the long­term period differed statistically significantly in favor of hybrid interventions (p=0,005).Conclusion. The hybrid technology of thoracic aorta reconstruction using “frozen elephant trunk” type allows to make one­step reconstruction of the aorta during its multilevel lesion. Observation of patients in the long­term period allows us to announce of a longtime, stable result of surgical treatment in the absence of additional perioperative risks.

Distal Malperfusion in Acute Type I Aortic Dissection: The Value of Endovascular Aortic Repair

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
K. Tsagakis ◽  
R. Jánosi ◽  
D. Dohle ◽  
J. Benedik ◽  
P. Kahlert ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Aortic Repair ◽  
Type I ◽  
Acute Type ◽  
Aortic Repair

Surgical treatment of acute type B aortic dissection associated with use of cocaine

2009 ◽  
Vol 150 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Zoltán Szeberin ◽  
Gábor Firneisz ◽  
Gábor Bíró ◽  
Gábor Viktor Szabó ◽  
Péter Sótonyi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection

A kokainfogyasztás gyakorisága Magyarországon is növekszik. E drog használata fokozott kockázatot jelent szív- és érrendszeri betegségek kialakulása, például aortadissectio szempontjából. Klinikánkon zajlik hazánkban a B típusú aortadissectiós betegek döntő többségének ellátása. Célkitűzés: Egy rendszeresen kokaint használó, akut B típusú aortadissectiót elszenvedett beteg műtéti kezelését mutatjuk be esetismertetésünkben, amely tudomásunk szerint az első hasonló eset hazánkban. Módszer: Esetleírás. Eredmények: Egy 35 éves férfi erős, mellkasi-háti-deréktáji fájdalmak miatt először a gerincsebészeti osztályhoz fordult, majd kiugróan magas vérnyomásértékek miatt belgyógyászati osztályra helyezték át. A B típusú aortadissectio diagnózisát CT-angiographia igazolta, a beteg érsebészeti centrumba került, ahol sikeres műtétet, thoracoabdominalis aortarefenesztrációt végeztünk. A beteg 3 hónappal a műtét után jól van, antihipertenzív szerek szedése mellett mindennapi feladatait ellátja, szövődményt nem észleltünk, a kokainról leszokott. Következtetések: Az akut B típusú dissectio sebészi ellátása megmentheti a beteg életét. A hosszú távú eredményes kezelésben a hipertónia kontrollja mellett a kokainról történő leszokás alapvető jelentőségű. Hasonló esetek előfordulására a kokainfogyasztás növekedése esetén hazánkban is számíthatunk.

Sign in / Sign up

Export Citation Format

Share Document