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Early-term surgical outcomes in current iAADA patients are better than those reported previously. Immediate surgical therapy results in acceptable outcomes similar to those in naturally occurring aortic dissection.
Maintaining perfusion pressure at physiologic levels during normothermic CPB (80-90 mm Hg) is associated with less early postoperative cognitive dysfunction and delirium. This perfusion strategy neither increases morbidity, nor does it impair organ function.
Geometry of the thoracic aorta is affected by aortic dissection, leading to an increase in diameter that is most pronounced in the ascending aorta. Both spontaneous and retrograde dissection result in similar aortic geometry changes.
Limiting the extent of surgery for type A aortic dissection to ascending aortic replacement was associated with low perioperative mortality. Thus, aortic arch repair can be deferred, because it can be performed electively with a lower mortality risk.
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