Acute type B aortic dissection: surgical therapy

摘要: Abstract Background Surgery for acute type B aortic dissection is associated with significant mortality. We report the results 34 consecutive patients who underwent urgent surgery because they met criteria operation during phase ( Methods The average patient age was 64 (32 to 88) years. Indications were persistent pain (12), threatened exsanguination (18), malperfusion (renal [3], limb [3]), rapid enlargement (4), and uncontrolled hypertension (1). mean interval from onset of 7 (1 14) days. Resection included proximal descending aorta in 32, distal arch 10, extension diaphragm involved a thoracoabdominal procedure 3. Surgical techniques hypothermic circulatory arrest (16 [47%]), bypass, monitoring somatosensory-evoked potentials, sequential intercostal sacrifice (average, 5.6 pairs), cerebrospinal fluid drainage, steroid administration. Results There no hospital Important complications occurred 16 (47%): 10 respiratory requiring tracheostomy, six infectious, four dialysis, two myocardial infarctions, neurologic (one transient stroke, one paraplegia). Mean intensive care unit stays (3 32) 35 (7 107) Survival at 5 years 80% 57%, respectively (mean follow-up, 5.8 years). Conclusions Patients meeting have low perioperative risk mortality paraplegia, are relatively free long-term aorta-related complications. These findings warrant consideration earlier appropriate dissection.