Surgical Treatment of Patient with Ruptured Dissection of the Thoracic Aorta – Stanford A, De Bakey I – Case Report of the Patient Surgically Treated at UC of State Cardiosurgery – Skopje

Abstract

Introduction. A 59-year-old male patient with dissection of the thoracic aorta, DeBakey I, Stanford A is presented in this case study. We present his symptoms, his preoperative condition, diagnostic procedures, the surgical procedure and his postoperative treatment at the UC of State Cardiosurgery-Skopje. Case report. The surgery was performed two days after establishment of the diagnosis and more than 3 days (72 hours) after the symptoms occured, due to absence of patient’s consent for the surgery. This resulted in more difficult preoperative condition of the patient, surgical procedure harder to perform, and reduced survival expectations. Preoperative risk of predicted mortality from the cardiovascular surgery calculated according to EUROSCORE was 28.6%. Results. In this case study we also present classification, etiology, pathophysiology, and some statistics about the incidence of thoracic aorta dissection and survival rates emphasizing the increased mortality rate in delayed surgical interventions.

A Cohort Study of Surgical Indexes, Postoperative Complications, Recovery Speed, and Prognosis of Stanford Type A Aortic Dissection Compared with Traditional Sun’s Operation

“…From the point of view of the type of operation, Sun's operation belongs to open surgery, while the debranching technique combined with thoracic aortic stent implantation is a hybrid technique of open surgery combined with stent intervention. However, how to choose the two surgical methods, their respective advantages and disadvantages, and the best surgical indications need to be further studied and discussed [10]. Dissection can involve all or parts of the abdominal aorta from the AA to the distal end, and the risk of rupture under the impact of high pressure blood fow is greatly increased.…”