Document Detail


Acute type A aortic dissection: 18 years of experience in one center (Hospital 12 de Octubre).
MedLine Citation:
PMID:  19502246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Here, we review our experience in acute type A aortic dissection analyzing the role of antegrade brain protection. A total of 105 patients underwent surgery for acute type A aortic dissection between March 1990 and October 2008. An open technique with deep hypothermia was used in 81 patients. Deep hypothermia alone was induced in 32 patients; in combination with retrograde cerebral perfusion in 26 patients and in combination with antegrade cerebral perfusion (ACP) in the final 23 patients. The overall hospital mortality rate was 15%. Hospital mortality risk factors were age >or=70 years and preoperative shock (P<0.05). Hospital mortality was reduced to 9% in the last 23 consecutive patients in whom ACP was accomplished (P=0.05). Survival rate after 1, 5, 10 and 15 years of follow-up was 97.6+/-1.7%, 84.3+/-4.4%, 60.7+/-7.5% and 57.1+/-7.8%, respectively. The only late death risk predictor was the non-use of ACP (P<0.05). Surgery for acute aortic dissection provides excellent results. ACP via the axillary artery improves the prognosis for these patients and should be the brain protection method of choice.
Authors:
Alberto Forteza; Carlos Martín; Jorge Centeno; María Jesús López; Enrique Pérez; Javier de Diego; Violeta Sánchez; José Cortina
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Publication Detail:
Type:  Journal Article     Date:  2009-06-05
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-18     Completed Date:  2009-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  426-30     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aneurysm, Dissecting / mortality,  physiopathology,  surgery*
Aortic Aneurysm / mortality,  physiopathology,  surgery*
Axillary Artery / physiopathology
Cerebrovascular Circulation
Cerebrovascular Disorders / etiology,  physiopathology,  prevention & control*
Circulatory Arrest, Deep Hypothermia Induced
Female
Hospital Mortality
Humans
Kaplan-Meiers Estimate
Logistic Models
Male
Middle Aged
Perfusion / methods*
Proportional Hazards Models
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Vascular Surgical Procedures* / adverse effects,  mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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