scholarly journals A Case of Emergency Ascending Aorta Replacement for Paraplegia Caused by Stanford Type A Acute Aortic Dissection

2011 ◽  
Vol 40 (5) ◽  
pp. 236-239
Author(s):  
Ryohei Matsuura ◽  
Nobuo Sakagoshi ◽  
Kenta Masada ◽  
Yasuhisa Shimazaki
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Ascending Aorta ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

scholarly journals Type A aortic dissection in aneurysms having modelled pre-dissection maximum diameter below 45 mm: should we implement current guidelines to improve the survival benefit of prophylactic surgery?

2020 ◽  
Author(s):  
Piergiorgio Tozzi ◽  
Ziyad Gunga ◽  
Lars Niclauss ◽  
Dominique Delay ◽  
Aurelian Roumy ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Survival Benefit ◽  
Type A ◽  
Ascending Aorta ◽  
Aortic Diameter ◽  
Maximum Diameter ◽  
Type A Aortic Dissection ◽  
Aorta Replacement ◽  
Current Guidelines ◽  
Ascending Aorta Replacement

Abstract OBJECTIVES Current guidelines recommend prophylactic replacement of the ascending aorta at an aneurysmal diameter of >55 mm to prevent acute Type A aortic dissection (TAAD) in non-Marfan patients. Several publications have challenged this threshold, suggesting that surgery should be performed in smaller aneurysms to prevent this devastating disease. We reviewed our experience with measuring aortic size at the time of TAAD to validate the existing recommendation for prophylactic ascending aorta replacement. METHODS All patients who had been admitted for TAAD to our emergency department from 2014 to 2019 and underwent ascending aorta replacement were included. Marfan patients were excluded. The maximum diameter of the dissected aorta was measured preoperatively using CT scan. We estimated the aortic diameter at the time of dissection to be 7 mm smaller than the measured maximum diameter of the dissected aorta (modelled pre-dissection diameter). RESULTS Overall, 102 patients were included. Of these, 67 were male (65.6%) and 35 were female (34.4%), and the cohort’s mean age was 65 ± 12.1 years. In addition, 66% were treated for arterial hypertension. The mean maximum modelled pre-dissection diameter was 39.6 ± 4.8 mm: 39.1 ± 5.1 mm in men and 40.7 ± 2.8 mm in women (P = 0.1). The cumulative 30-day mortality rate was 19.6% (20/102). CONCLUSIONS TAAD occurred at a modelled aortic diameter below 45 mm in 87.7% of our patients. Therefore, the current aortic diameter threshold of 55 mm excludes ∼99% of patients with TAAD from prophylactic replacement of the ascending aorta. The maximum diameter of the ascending aorta warrants reappraisal and this parameter should be a distinct part of a personalized decision-making process that also takes into account age, gender and body surface area to establish the surgical indication for preventive aorta replacement aimed to improve the survival benefit of this procedure.

Ascending aorta replacement and local repair of tear site in type a aortic dissection with arch tear

2003 ◽  
Vol 75 (6) ◽  
pp. 1785-1790 ◽  
Author(s):  
Kay-Hyun Park ◽  
Kiick Sung ◽  
Kwhanmien Kim ◽  
Tae-Gook Jun ◽  
Young Tak Lee ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Ascending Aorta ◽  
Local Repair ◽  
Type A Aortic Dissection ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

scholarly journals The fate of residual aortic regurgitation after ascending aorta replacement in type A aortic dissection

2020 ◽  
Vol 160 (6) ◽  
pp. 1421-1430.e5 ◽  
Author(s):  
Do Jung Kim ◽  
Sak Lee ◽  
Seung Hyun Lee ◽  
Young-Nam Youn ◽  
Byung-Chul Chang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Regurgitation ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

Cannulating a Dissecting Aorta Using Ultrasound-Epiaortic and Transesophageal Guidance

2011 ◽  
Vol 14 (6) ◽  
pp. 373 ◽  
Author(s):  
Saina Attaran ◽  
Maria Safar ◽  
Hesham Zayed Saleh ◽  
Mark Field ◽  
Manoj Kuduvalli ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
Complete Rupture

<p>Management of acute Stanford type A aortic dissection remains a major surgical challenge. Directly cannulating the ascending aorta provides a rapid establishment of cardiopulmonary bypass but consists of risks such as complete rupture of the aorta, false lumen cannulation, subsequent malperfusion and propagation of the dissection.</p><p>We describe a technique of cannulating the ascending aorta in patients with acute aortic dissection that can be performed rapidly in hemodynamically unstable patients under ultrasound-epiaortic and transesophageal (TEE) guidance.</p>

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