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[Operative decision for acute type A aortic dissection; ascending aorta or arch replacement].
Yasushige Shingu1, H Aoki, J Oba
1Department of Thoracic Surgery, Asahikawa City Hospital, Asahikawa, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 12, 2005
Summary
This study shows that replacing the ascending aorta or hemiarch is a viable surgical option for acute type A aortic dissection, particularly in elderly patients. The procedure often leads to false lumen thrombosis, minimizing distal aortic enlargement.
Area of Science:
- Cardiovascular Surgery
- Thoracic Aortic Disease
- Aortic Dissection Management
Context:
- Operative techniques for acute type A aortic dissection are debated.
- Limited data exists on ascending aorta and hemiarch replacement strategies.
- The fate of the distal false lumen after such procedures requires further investigation.
Purpose:
- To evaluate the feasibility of ascending aorta and hemiarch replacement for acute type A aortic dissection.
- To assess the long-term patency and thrombosis of the false lumen distal to the anastomosis.
- To determine the impact of this surgical strategy on distal aortic dimensions.
Summary:
- Nineteen patients with acute type A aortic dissection underwent ascending aorta or hemiarch replacement.
- The early mortality rate was 10.5%.
- In De Bakey type I dissections, 60% of patients showed thrombosis of the distal false lumen, with minimal distal aortic enlargement.
Impact:
- Ascending aorta and hemiarch replacement, combined with entry closure, presents a reasonable surgical option for acute type A aortic dissection, especially in the elderly.
- The strategy promotes distal false lumen thrombosis, suggesting a favorable outcome for the dissected aorta.
- This approach may reduce the need for more extensive aortic arch replacement in select patients.