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Changing Surgical Management for Acute Aortic Dissections Type A Improves Immediate Outcomes
Author(s) -
Sierra Jorge,
Christenson Jan T.,
Kalangos Afksendiyos
Publication year - 2005
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2005.200417.x
Subject(s) - medicine , aortic dissection , surgery , cerebral perfusion pressure , mortality rate , dissection (medical) , perfusion , aneurysm , aorta , cardiology
Background: Surgical treatment of acute aortic dissection type A is well established. This study analyzes the impact of changing surgical management of Type A dissections on hospital mortality and postoperative complications. Method: Between January 1980 and December 2002, 141 consecutive patients were operated for acute Type A aortic dissection. Patients were analyzed in 3 time periods; 1980–1989, n = 26, 1990–1999, n = 71 and 2000–2002, n = 44). Antegrade cerebral perfusion via subclavian cannulation, a more extensive resection as well as valvar repair was introduced as routine procedures from January 2000. Results: Mortality and neurological complications decreased over time; from 31% to 9.1% and from 27% to 2.5%, respectively. During follow‐up, 14 patients (12%) required surgical re‐intervention for aneurysms (1 to 17 years later) with associated hospital mortality of 21%. Conclusions: Antegrade cerebral perfusion reduces neurological complications and more extensive surgical approach did not increase mortality and morbidity.