Long-Term Results After 27 Years of Surgical Treatment of Acute Type A Aortic Dissection

Tan, Mengwei; Morshuis, Wim J.; Dossche, Karl M.; Kelder, Johannes C.; Waanders, Frans G.; Schepens, Marc A.A.M.

doi:10.1016/j.athoracsur.2005.02.059

Cited by 84 publications

(57 citation statements)

References 18 publications

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“…[1][2][3][4][5][6][7][8][9][10] Far fewer studies have been published on results of examination of the operatively resected portion of the ascending aorta. [11][12][13][14][15][16][17][18][19][20][21] The present report focuses on aortic medial elastic-fiber structure in 69 patients having portions of the ascending aorta operatively resected because of acute dissection involving the ascending aorta with or without involvement of other portions of the aorta.…”

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confidence: 99%

Aortic Medial Elastic Fiber Loss in Acute Ascending Aortic Dissection

Roberts

Vowels

Kitchens

et al. 2011

The American Journal of Cardiology

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The cause of acute aortic dissection continues to be debated. One school of thought suggests that underlying aortic medial cystic necrosis is the common denominator. The purpose of the present study was to determine if there was loss and, if so, how much loss of medial elastic fibers in the ascending aorta in patients with acute aortic dissection with the entrance tear in the ascending aorta. We examined operatively excised ascending aortas in 69 patients having acute dissection with tears in the ascending aorta. Patients with previous aortotomy, healed dissection, and connective tissue disorders were excluded. The 69 patients' ages ranged from 31 to 88 years (mean 56); 49 were men and 20 were women. Loss of aortic medial elastic fibers was graded as 0 (no loss), 1؉ (trace), 2؉ (mild), 3؉ (moderate), and 4؉ (full thickness loss). Of these 69 patients, 56 (82%) had 0 or 1؉ elastic fiber loss; 13 patients (18%), 2؉ to 4؉ loss including 4 with 2؉, 6 with 3؉, and 2 with 4؉. Nearly all patients (97%) had a history of systemic hypertension and/or had received antihypertensive drug therapy. In conclusion, most patients (82% in this study) having acute aortic dissection with entrance tears in the ascending aorta have normal numbers or only trace loss of aortic medial elastic fibers. Thus, underlying abnormal ascending aortic structure uncommonly precedes acute dissection.

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confidence: 99%

Aortic Medial Elastic Fiber Loss in Acute Ascending Aortic Dissection

Roberts

Vowels

Kitchens

et al. 2011

The American Journal of Cardiology

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“…En nuestro país, Selman et al, mediante un análisis retrospectivo, registraron una mortalidad operatoria de 27%, en 85 pacientes con DA tipo A 41 . Promedios similares se han publicado en otros reportes y alrededor de 55% de los pacientes retorna a su vida independiente [50][51][52][53] . Con respecto a la DA tipo B, el tratamiento va a depender de la presencia de complicaciones.…”

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Síndrome aórtico agudo: Revisión de la literatura y actualización del tema

Zamorano

et al. 2014

Rev. méd. Chile

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“…The regions with the highest risk of developing an aneurysm are the distal arch and proximal descending thoracic aorta (DTA) (17,(22)(23)(24). In patients undergoing DBT1-AAD repair, freedom from aortic reoperation at 10 years ranges from 61% to 74% (10,20,25). To reduce the frequency of late aneurysm formation and reoperation, some surgeons have been motivated to perform more aggressive primary operations, all associated with strengths and weaknesses.…”

Section: Perspectivementioning

confidence: 99%

Descending endograft for DeBakey type 1 aortic dissection: pro

Berretta¹,

Eusanio²

2016

Ann. Cardiothorac. Surg.

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The surgical management of patients with DeBakey type 1 acute aortic dissection (DBT1-AAD) represents a major challenge for aortic surgeons. It has been demonstrated that the distal false lumen remains patent in about 70% to 80% of patients undergoing DBT1-AAD surgery and that a patent false lumen worsens the prognosis. In order to improve long term outcomes and reduce the frequency of late aneurysm formation and reoperation, a more aggressive primary operation involving total arch replacement (TAR) and concomitant antegrade stenting of the descending thoracic aorta (DTA) with a frozen elephant trunk (FET) has been introduced. Such extensive operations, however, remain controversial due to their increased technical complexity and perceived higher operative mortality and morbidity. This perspective article will overview the rationale behind, and the potential advantages and current evidence for, FET surgery in acute aortic dissection.

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Long-Term Results After 27 Years of Surgical Treatment of Acute Type A Aortic Dissection

Cited by 84 publications

References 18 publications

Aortic Medial Elastic Fiber Loss in Acute Ascending Aortic Dissection

Aortic Medial Elastic Fiber Loss in Acute Ascending Aortic Dissection

Síndrome aórtico agudo: Revisión de la literatura y actualización del tema

Descending endograft for DeBakey type 1 aortic dissection: pro

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