Extended and Total Aortic Resection in the Surgical Treatment of Acute Type A Aortic Dissection: Experience with 54 Patients

Massimo, C; Presenti, L; Marranci, Piezluigi; Favi, P; Poma, Alberto G.; Ponzalli, Maurizio; Viligiardi, Riccardo

doi:10.1016/s0003-4975(10)64656-5

Cited by 86 publications

(22 citation statements)

References 13 publications

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“…Although retrograde AD occurs more commonly than is generally realized, 3,6,7,9,17,18 there are few reports about natural history and specific therapeutic problems of patients with retrograde AD. [3][4][5]9 The precise clinical, aortographic, and pathologic features of 6 patients who presented with acute retrograde dissection of the ascending aorta was reported by Cipiriano et al 3 They recommended early surgery for these patients with retrograde AD.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta

Kaji

Katayama²,

Yamamuro³

et al. 2003

Circulation

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Background-Natural history of aortic dissection (AD) with intimal tear in the descending or abdominal aorta and retrograde extension into the ascending aorta (retrograde AD) remains unknown. The purpose of this study was to elucidate medium-term prognosis of patients with retrograde AD. Methods and Results-Study population consisted of 109 patients with acute type A AD. There were 27 patients (25%) with retrograde AD and 82 patients (75%) with intimal tear in the ascending aorta (antegrade AD). In antegrade AD patients, 60 patients underwent surgery and 22 patients were treated medically. In retrograde AD patients, 14 patients showed localized crescentic high attenuation area along the ascending aortic wall without enhancement in computed tomography. Transesophageal echocardiography revealed complete thrombosis of false lumen (FL) in the ascending aorta (retrograde thrombosed). The remaining 13 patients showed incomplete or no thrombosis (retrograde nonthrombosed). All retrograde nonthrombosed AD patients underwent surgery except for 1 patient with stroke, whereas all retrograde thrombosed AD patients were treated medically. In-hospital mortality rate of retrograde AD patients was significantly lower than that of antegrade AD patients (15% versus 38%, Pϭ0.027). The survival rates in retrograde AD patients were all 85% at 1, 2, and 5 years, which were significantly higher than those of antegrade AD patients (63%, 62%, and 57%, respectively)(Pϭ0.009). Conclusions-Patients

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Section: Discussionmentioning

confidence: 99%

Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta

Kaji

Katayama²,

Yamamuro³

et al. 2003

Circulation

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“…7,8 Recently, Kato and coworkers 9,10 developed a hybrid technique in which the ascending aorta and aortic arch were replaced with a 4-branched graft and a conventional straight stent graft was implanted into the descending aorta for acute type A aortic dissection. This hybrid technique not only provided easy management of the distal aortic anastomosis but also was an effective way to close the residual false lumen of the descending aorta.…”

mentioning

confidence: 99%

Extensive Primary Repair of the Thoracic Aorta in Acute Type A Aortic Dissection by Means of Ascending Aorta Replacement Combined With Open Placement of Triple-Branched Stent Graft

et al. 2010

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“…1 Even with careful control and prevention of various complications, new dissecting aneurysms in the residual aorta or recurrence of dissection 2 will occur, and finally a total aortic graft replacement will become necessary. Massimo et al 3 have reported cases where the total aortic replacement has been performed as a singlestaged operation. However, postoperative complications are still difficult to avoid.…”

Section: Discussionmentioning

confidence: 99%

Successful graft replacement of the descending aorta after an extended reconstruction of the ascending and transverse aorta in a patient with marfan’s syndrome

et al. 1998

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A 27-year-old man with Marfan's syndrome underwent a total aortic graft replacement in three separate stages. Initially the abdominal aorta was replaced, followed by the ascending aorta and aortic arch, and finally the residual portion. The extensive reconstruction of both the ascending and transverse aorta at the second operation, even though no dissection was present in the aortic arch, reduced the risk of the subsequent operation since the same surgical approach did not have to be used.

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Extended and Total Aortic Resection in the Surgical Treatment of Acute Type A Aortic Dissection: Experience with 54 Patients

Cited by 86 publications

References 13 publications

Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta

Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta

Extensive Primary Repair of the Thoracic Aorta in Acute Type A Aortic Dissection by Means of Ascending Aorta Replacement Combined With Open Placement of Triple-Branched Stent Graft

Successful graft replacement of the descending aorta after an extended reconstruction of the ascending and transverse aorta in a patient with marfan’s syndrome

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