HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kazui, T. Articles by Komatsu, S. Search for Related Content PubMed PubMed Citation Articles by Kazui, T. Articles by Komatsu, S.

J Thorac Cardiovasc Surg 1996;112:973-978
© 1996 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

EXTENDED AORTIC REPLACEMENT FOR ACUTE TYPE A DISSECTION WITH THE TEAR IN THE DESCENDING AORTA

From the Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.

Received for publication April 11, 1996 Revisions requested May 14, 1996; revisions received June 11, 1996 Accepted for publication June 13, 1996. Address for reprints: Teruhisa Kazui, MD, Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1, West 17, Chuo-ku, Sapporo 060, Japan.

Abstract

Objective: There has been controversy as to the selection of surgical treatments for acute type A dissection with the tear in the descending thoracic aorta, a subtype of acute aortic dissection in which the limited tear is located distal to the left subclavian artery but the dissection extends retrogradely to the ascending aorta. Methods: Total replacement of the ascending aorta and aortic arch was performed in 12 patients with acute type A dissection with the tear in the descending thoracic aorta between March 1991 and the end of September 1995. The indications for total replacement of the ascending aorta and aortic arch were cardiac tamponade, acute aortic regurgitation, cerebral ischemia, and dilatation of the ascending aorta. The operation was performed with the aid of extracorporeal circulation, blood cardioplegia, selective cerebral perfusion, and open distal anastomosis. The surgical procedure used was total replacement of the ascending aorta and aortic arch with a graft provided with three limbs accompanied by resection of the intimal tear in the descending thoracic aorta. Results: Hospital death occurred in two patients (16.7%). In both, death was due to dissection/related complications of renal/mesenteric ischemia. The other 10 patients have had uneventful postoperative courses over a mean period of 24 months. Conclusions: Total replacement of the ascending aorta and aortic arch accompanied by resection of an intimal tear distal to the left subclavian artery seems to be justified in selected patients with acute type A dissection with the tear in the descending thoracic aorta. (J THORAC CARDIOVASC SURG 1996;112:973-8)

This article has been cited by other articles:

				L. Gobolos, A. Philipp, M. Foltan, and K. Wiebe Surgical management for Stanford type A aortic dissection: direct cannulation of real lumen at the level of the Botallo's ligament by Seldinger technique Interactive CardioVascular and Thoracic Surgery, December 1, 2008; 7(6): 1107 - 1109. [Abstract] [Full Text] [PDF]

				W. Swee and M. D. Dake Endovascular Management of Thoracic Dissections Circulation, March 18, 2008; 117(11): 1460 - 1473. [Full Text] [PDF]

				B. Neuhauser, A. Greiner, W. Jaschke, A. Chemelli, and G. Fraedrich Serious complications following endovascular thoracic aortic stent-graft repair for type B dissection Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 58 - 63. [Abstract] [Full Text] [PDF]

				Y. Moizumi, N. Motoyoshi, K. Sakuma, and S. Yoshida Axillary Artery Cannulation Improves Operative Results for Acute Type A Aortic Dissection Ann. Thorac. Surg., July 1, 2005; 80(1): 77 - 83. [Abstract] [Full Text] [PDF]

				M. E. S. H. Tan, K. M. E. Dossche, W. J. Morshuis, J. C. Kelder, F. G. J. Waanders, and M. A.A.M. Schepens Is extended arch replacement for acute Type A aortic dissection an additional risk factor for mortality? Ann. Thorac. Surg., October 1, 2003; 76(4): 1209 - 1214. [Abstract] [Full Text] [PDF]

				S. Kaji, T. Akasaka, M. Katayama, A. Yamamuro, K. Yamabe, K. Tamita, M. Akiyama, N. Watanabe, K. Tanemoto, S. Morioka, et al. Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta Circulation, September 9, 2003; 108(90101): II-300 - 306. [Abstract] [Full Text] [PDF]

				S. D. Moffatt and R. S. Mitchell Endovascular Stent Management of Thoracic Aneurysms and Dissections Card. Surg. Adult, January 1, 2003; 2(2003): 1191 - 1204. [Full Text]

				R. S. Mitchell Stent grafts for the thoracic aorta: a new paradigm? Ann. Thorac. Surg., November 1, 2002; 74(5): S1818 - 1820. [Abstract] [Full Text] [PDF]

				Y. Hanafusa, H. Ogino, H. Sasaki, K. Minatoya, M. Ando, Y. Okita, and S. Kitamura Total arch replacement with elephant trunk procedure for retrograde dissection Ann. Thorac. Surg., November 1, 2002; 74(5): S1836 - 1839. [Abstract] [Full Text] [PDF]

				N. Kato, T. Shimono, T. Hirano, T. Suzuki, M. Ishida, H. Sakuma, I. Yada, and K. Takeda Midterm results of stent-graft repair of acute and chronic aortic dissection with descending tear: The complication-specific approach J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 306 - 312. [Abstract] [Full Text] [PDF]

				H. Ishihara, N. Uchida, C. Yamasaki, M. Sakashita, and M. Kanou Extensive primary repair of the thoracic aorta in Stanford type A acute aortic dissection by means of a synthetic vascular graft with a self-expandable stent J. Thorac. Cardiovasc. Surg., June 1, 2002; 123(6): 1035 - 1040. [Abstract] [Full Text] [PDF]

				K. Imanaka, S. Kyo, M. Kato, H. Tanabe, H. Ohuchi, H. Asano, and Y. Yokote A simple and useful option for treatment of acute type A dissection with the tear beyond the aortic arch J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 1001 - 1003. [Full Text] [PDF]

				K. Kawahito, H. Adachi, A. Yamaguchi, and T. Ino Early and late surgical outcomes of acute type a aortic dissection in patients aged 75 years and older Ann. Thorac. Surg., November 1, 2000; 70(5): 1455 - 1459. [Abstract] [Full Text] [PDF]

				T. Kazui, N. Washiyama, B. A. H. Muhammad, H. Terada, K. Yamashita, M. Takinami, and Y. Tamiya EXTENDED TOTAL ARCH REPLACEMENT FOR ACUTE TYPE A AORTIC DISSECTION: EXPERIENCE WITH SEVENTY PATIENTS J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 558 - 565. [Abstract] [Full Text] [PDF]

				T. Koshino, K. Morishita, Y. Tamiya, J. Fukada, and T. Abe Enlargement of ulcer-like projections after repair of acute type A aortic dissection Ann. Thorac. Surg., November 1, 1999; 68(5): 1860 - 1863. [Abstract] [Full Text] [PDF]

				M. D. Dake, N. Kato, R. S. Mitchell, C. P. Semba, M. K. Razavi, T. Shimono, T. Hirano, K. Takeda, I. Yada, and D. C. Miller Endovascular Stent-Graft Placement for the Treatment of Acute Aortic Dissection N. Engl. J. Med., May 20, 1999; 340(20): 1546 - 1552. [Abstract] [Full Text] [PDF]