scholarly journals The considerations of surgical treatment strategies of acute type a aortic dissection

2016 ◽  
Vol 152 (3) ◽  
pp. 935-937 ◽  
Author(s):  
Cun-tao Yu
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Treatment Strategies ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

Extended and Total Aortic Resection in the Surgical Treatment of Acute Type A Aortic Dissection: Experience with 54 Patients

1988 ◽  
Vol 46 (4) ◽  
pp. 420-424 ◽  
Author(s):  
Carlo G. Massimo ◽  
Luigi F. Presenti ◽  
Piezluigi Marranci ◽  
Piero P. Favi ◽  
Alberto G. Poma ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

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.

scholarly journals Influence of False Lumen Status on the Prognosis of Acute Type A Aortic Dissection without Urgent Surgical Treatment

2017 ◽  
Vol 24 (2) ◽  
pp. 169-175
Author(s):  
Akihito Tanaka ◽  
Hideki Ishii ◽  
Susumu Suzuki ◽  
Tomoyuki Ota ◽  
Hideki Oshima ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

Surgical treatment for acute type A aortic dissection during pregnancy (16 weeks) with Loeys-Dietz syndrome

2012 ◽  
Vol 60 (11) ◽  
pp. 764-767 ◽  
Author(s):  
Hideyuki Kunishige ◽  
Yoshimitsu Ishibashi ◽  
Masakazu Kawasaki ◽  
Tomoji Yamakawa ◽  
Kiyotaka Morimoto ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

Late aortic root redissection following surgical treatment for acute type A aortic dissection using Gelatin-Resorcin-Formalin glue

2002 ◽  
Vol 50 (5) ◽  
pp. 195-200 ◽  
Author(s):  
Kotaro Suehiro ◽  
Takato Hata ◽  
Hidenori Yoshitaka ◽  
Yoshimasa Tsushima ◽  
Mitsuaki Matsumoto ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Aortic Root ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

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 Acute type A aortic dissection: Aortic Dissection Detection Risk Score in emergency care – surgical delay because of initial misdiagnosis

2020 ◽  
Vol 9 (3_suppl) ◽  
pp. S40-S47 ◽  
Author(s):  
Lisa Zaschke ◽  
Helmut Habazettl ◽  
Jana Thurau ◽  
Christian Matschilles ◽  
Amélie Göhlich ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Risk Score ◽  
Correct Diagnosis ◽  
Type A ◽  
Initial Diagnosis ◽  
Lumbar Pain ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Positive Score

Background: Acute type A aortic dissection requires immediate surgical treatment, but the correct diagnosis is often delayed. This study aimed to analyse how initial misdiagnosis affected the time intervals before surgical treatment, symptoms associated with correct or incorrect initial diagnosis and the potential of the Aortic Dissection Detection Risk Score to improve the sensitivity of initial diagnosis. Methods: We conducted a retrospective analysis of 350 patients with acute type A aortic dissection. Patients were divided into two groups: initial misdiagnosis (group 0) and correct initial diagnosis of acute type A aortic dissection (group 1). Symptoms were analysed as predictors for the correct or incorrect initial diagnosis by multivariate analysis. Based on these findings, the Aortic Dissection Detection Risk Score was calculated retrospectively; a result ⩾2 was defined as a positive score. Results: The early suspicion of aortic dissection significantly shortened the median time from pain to surgical correction from 8.6 h in patients with an initial misdiagnosis to 5.5 h in patients with the correct initial diagnosis ( p<0.001). Of all acute type A aortic dissection patients, 49% had a positive Aortic Dissection Detection Risk Score. Of all initial misdiagnosed patients, 41% had a positive score (⩾2). The presence of lumbar pain ( p<0.001), any paresis ( p=0.037) and sweating ( p=0.042) was more likely to lead to the correct initial diagnosis. Conclusion: An early consideration of acute aortic dissection may reduce the delay of surgical care. The suggested Aortic Dissection Detection Risk Score may be a useful tool to improve the preclinical assessment.

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