[Surgical treatment of acute Stanford Type-A aortic dissection]

Twelve cases of Stanford Type-A aortic dissection were operated in an acute phase. The male vs female ratio was 3:9, and their ages ranged from 47 to 79 (mean 61.3) years old. Most of them complained of chest and/or back pain, and four of them complained of syncope. Eight patients had the history of hypertension. As to the complications of aortic dissection, cardiac tamponade was seen in two cases, myocardial infarction in one, and transient hemiplegia and paraplegia in one case each. In five cases, moderate to severe aortic regurgitation was also noted. All but one case were operated within twenty-four hours after admission. The replacement of the ascending aorta with a tube graft was performed in all cases including the two cases whose entries were located in the aortic arch. CABG was done concomitantly in three cases, and aortic valve replacement and CABG in one case. The open distal anastomosis was carried out under the systemic circulatory arrest combined with the retrograde cerebral perfusion. The systemic perfusion was reinstituted after the distal anastomosis was completed. In cases whose dissecting pseudo-lumen of the distal aorta was not thrombosed, the arterial cannulation site was shifted from the femoral artery to the tube graft. All but two cases were discharged from the hospital in good condition. One case, who had been transferred to the operating room under cardiac massage due to myocardial infarction, was lost by severe LOS three weeks postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)