Document Detail


Comparison of operative techniques in acute type A aortic dissection performing the distal anastomosis.
MedLine Citation:
PMID:  17338742     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of our retrospective study was to evaluate early and midterm clinical outcomes of two surgical techniques: open anastomosis in deep hypothermic circulatory arrest (DHCA) compared to anastomosis with clamped aorta while continuing on extracorporeal circulation (CECC). METHODS: Between November 1997 and February 2002, 67 patients were operated for acute type A aortic dissection. Records of 35 patients with isolated replacement of the ascending aorta without intervention on the aortic arch were retrospectively reviewed. The influence of two techniques (DHCA n = 15, CECC n = 20) on clinical outcome and midterm follow up was investigated. RESULTS: There were no statistically significant differences in preoperative data. Female gender in the DHCA group was coincidentally more frequent. Intraoperative management did not result in different early clinical outcome. 30-day mortality was not statistically different. Mean follow up time was 20.7 +/- 11.1 months in the DHCA group and 28.7 +/- 14.3 months in the CECC group. One-year and 3-year survival estimates in DHCA group were 85%+/- 7% and 79%+/- 9%, respectively. In the CECC group similar survivals were 80%+/- 10% and 73%+/- 11%, respectively. No statistically significant differences between the two groups were obtained in early or midterm outcome. CONCLUSION: While there is no difference in clinical outcome in surgical treatment of acute type A aortic dissection with or without circulatory arrest, there are some practical technical advantages if the distal anastomosis is performed in an open manner. Probably the long-term outcome too is better with this anastomosis technique.
Authors:
Bernhard C Danner; Ehsan Natour; Michael Horst; Valentin Dikov; Probal K Ghosh; Otto E Dapunt
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  22     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2007 Mar-Apr
Date Detail:
Created Date:  2007-03-06     Completed Date:  2007-08-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Klinikum Oldenburg, Oldenburg, Germany. bernhard.danner@dgn.de
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Anastomosis, Surgical / methods
Aneurysm, Dissecting / surgery*
Aortic Aneurysm, Abdominal / surgery*
Aortic Aneurysm, Thoracic / surgery*
Blood Vessel Prosthesis Implantation / methods*
Circulatory Arrest, Deep Hypothermia Induced
Extracorporeal Circulation
Female
Follow-Up Studies
Humans
Male
Middle Aged
Research Design
Retrospective Studies
Survival Analysis
Time Factors
Treatment Outcome

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


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