Supracommissural Aortic Replacement: A Reliable Option for Acute and Chronic Aortic Type A Dissection

Abstract

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : To re vi ew early and la te re sults of sup ra com mis su ral aor tic rep la ce ment in pa ti ents with acu te and chro nic type A dis sec ti on. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : From Feb ru ary 1985 to Oc to ber 2005, 162 pa ti ents with acu te and chro nic aor tic dis sec ti on un der went sup ra com mis su ral aor tic graft rep la ce ment. A ret ros pec ti ve cli ni cal re vi ew was un der ta ken using hos pi tal re cords, clini cal and ec ho car di og rap hic da ta, and te lep ho ne in ter vi ews with pa ti ents. R Re e s su ul lt ts s: : The re we re 23 (14.1 %) ope ra ti ve and eight (6.4 %) la te de aths. The most com mon ca u ses of hos pi tal de ath we re in tra o pe ra ti ve comp li ca ti ons re la ted to he morr ha ge (n= 9), and res pi ra tory fa i lu re (n = 6), and the ot her ca u se was mul ti or gan fa i lu re (n= 5). The hos pi tal mor ta lity ra te for pa ti ents with chro nic type A dis sec ti on was 6.25% (3/48). The ca u ses of de ath we re res pi ra tory fa i lu re (n= 2) and mul ti or gan fa i lu re (n= 1). The mo des of hos pi tal de aths we re not re la ted to re si du al aor tic in suf fi ci ency (AR) in any ca se sin ce early pos to pe ra ti ve trans tho ra cic ec ho car di og raphy did not show gra ter than grade II in the se pa ti ents in early pos to pe ra ti ve or fol low-up pe ri od, trans tho ra cic ec ho car di og raphy did not show aor tic re gur gi ta ti on gra ter than gra de II in any ca se. All sur vi vors we re in New York He art As so ci a ti on class I or II at the last vi sit. C Co on nc c l lu u s si i o on n: : Sup ra com mis su ral aor tic graft rep la cement pro vi des sa tis fac tory re sults for many pa ti ents with as cen ding aor tic dis sec ti on. The func ti on of the pre ser ved aor tic val ves re ma i ned unc han ged in the ma jo rity of the pa ti ents du ring the first fi ve ye ars of fol low-up. K Ke ey y W Wo or rd ds s: : Aor ta; aor tic val ve in suf fi ci ency; aor tic val ve Ö ÖZ ZE ET T A Am ma aç ç: : Sup ra ko mis su ral aort rep las ma nı uy gu la nan akut ve kro nik Tip A aort dis sek si yon lu ol gu la rın er ken ve geç dö nem so nuç la rı nın göz den ge çi ril me si. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Şubat 1985 ile Ekim 2005 ta rih le ri ara sın da akut ve kro nik dis sek si yo nu olan 162 ol gu ya sup ra kom mis su ral aort gretf rep las ma nı uy gu lan dı. Kli nik bul gu lar ret ros pek tif ola rak has ta ka yıt la rı, kli nik ve eko kar diyog ra fik bul gu lar ve has ta lar la te le fon gö rüş me le ri ile sağ lan dı. B Bu ul l g gu u l la ar r: : Yir mi üç (%14.1) ope ratif, se kiz (%5.8) geç dö nem mor ta li te si mev cut tu. En sık ölüm ne den le ri, in tra o pe ra tif komp li kasyon la ra bağ lı ola rak, ka na ma (n=9), so lu num yet mez li ği (n= 6) ve di ğer se bep ola rak da mul ti or gan yet mez li ği (n= 5) idi. Kro nik tip A dis sek si yon ol gu la rın da has ta ne mor ta li te si 6.25% (3/48) idi. Ölüm se bep le ri; so...