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[Surgical treatment of De Bakey type III aortic dissection]
Qian Chang1, Lizhong Sun, Junming Zhu
1Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Objective:
To summarize the experience in surgical treatment of De Bakey type III aortic dissection and discuss the operative indications, techniques, and methods for spinal cord protection.
Methods:
From January 1994 to January 2000, 49 patients with De Bakey type III aortic dissection were operated on. Of these patients, 35 were subjected to partial thoratical aorta replacement, 4 partial thoratical aorta replacement and plasty, 8 total thoratical aorta replacement, and 2 thoracoabdominal aorta replacement. In the 35 patients, the operations were performed by using the technique which preserved blood was transfused back by pump via the femoral artery.
Results:
Hospital mortality in this group was 6.1% (3/49). Eight patients received emergence operation, and 1 patient died. Paraparesis developed in one patient (2.0%). Other complications included re-exploration for bleeding in 3 patients, and wound infection in 5.
Conclusions:
The rate of mortality and complication is high in patients with De Bakey type III aortic dissection. Appropriate operative techniques and methods of spinal cord protection are essential to resolve this problem.