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Surgery for aortic dissection with intimal tear in the transverse aortic arch
1Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Summary
Surgical repair of aortic dissection involving the aortic arch provides satisfactory early and late outcomes. Resection of the intimal tear site and graft replacement ensures long-term survival and reduces reoperation rates.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Aortic dissection involving the transverse aortic arch presents unique surgical challenges.
- Optimal surgical strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To report the surgical experience and outcomes of patients with aortic dissection and intimal tears in the transverse aortic arch.
- To evaluate the efficacy of aortic segment resection and graft replacement.
Main Methods:
- Retrospective analysis of 72 patients undergoing aortic arch dissection repair.
- Procedures included total or hemiarch replacement, with selective or retrograde cerebral perfusion.
- Data collected on demographics, dissection extent, surgical techniques, and outcomes.
Main Results:
- Hospital mortality was 9.7%, with no deaths since February 1993.
- Five and 10-year survival rates were 85.3% and 79.8% for extensive dissections, and 93.5% for localized dissections.
- Freedom from reoperation at 10 years was 65.6% overall, with better outcomes for localized dissections.
Conclusions:
- Surgical repair of aortic arch dissection with intimal tears yields satisfactory early and late results.
- Resection of the affected aortic segment and graft replacement is an effective surgical principle.
- This approach contributes to favorable long-term survival and reduced reoperation rates.