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[Vascular complications associated with aortic dissection].

T Carrel1, R Jenny, G Suetsch

  • 1Clinique de chirurgie cardio-vasculaire, Hôpital universitaire, Zurich.

Schweizerische Medizinische Wochenschrift
|July 27, 1991
PubMed
Summary
This summary is machine-generated.

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Acute aortic dissection can cause dangerous blockages in aortic branches. Treating these vascular complications is crucial, with proximal aortic repair showing promise in restoring blood flow and reducing mortality.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Context:

  • Acute aortic dissection frequently involves aortic branch occlusion, impacting presentation and treatment strategies.
  • Management of associated cerebral, visceral, and peripheral vascular complications remains incompletely defined.
  • This study reviews outcomes in patients with acute thoracic aortic dissection and non-cardiac vascular complications.

Purpose:

  • To assess the incidence, consequences, and management of aortic branch stenotic and obstructive lesions in acute aortic dissection.
  • To evaluate the impact of these complications on surgical outcomes and mortality.
  • To determine the effectiveness of proximal aortic repair in addressing malperfusion.

Summary:

  • A review of 187 patients with acute thoracic aortic dissection found non-cardiac vascular complications in 32% (28% for Type A, 48% for Type B).

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  • Surgical mortality decreased significantly over the study period (28% to 12%).
  • While aortic rupture and tamponade were primary mortality factors, branch malperfusion, especially in carotid, celio-mesenteric, and renal arteries, increased death risk. Proximal aortic repair improved distal perfusion in 27 patients, with 15 requiring additional procedures.

    • Impact:

    • Highlights the significant morbidity and mortality associated with aortic branch complications in acute aortic dissection.
    • Demonstrates the potential benefit of proximal aortic repair in resolving malperfusion syndromes.
    • Informs therapeutic strategies for managing complex aortic dissection cases involving vascular compromise.