Document Detail


Operation for acute and chronic aortic dissection: recent outcome with regard to neurologic deficit and early death.
MedLine Citation:
PMID:  9725376     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We reviewed our experience in the repair of acute and chronic aortic dissection with regard to early neurologic deficit and death. METHODS: Between February 1991 and June 1996, we performed 206 operations on 195 patients for aortic dissection. Ascending or arch repair, or a combination (type A dissection) was performed on 92 of 206 patients (45%); 44 of 92 (48%) were acute dissection and 48 of 92 (52%) were chronic. Descending or thoracoabdominal repair (type B dissection) was performed on 114 of 206 patients (55%); 22 of 114 (19%) were acute and 92 of 114 (81%) were chronic. RESULTS: Among type A cases, strokes occurred in 6 of 92 patients (7%) overall; 4 of 44 (9%) were acute cases and 2 of 48 (4%) were chronic (p < 0.34). Early deaths for type A were 11 of 92 (12%) overall; 9 of 44 (20%) acute and 2 of 48 (4%) chronic (p < 0.02). In type B cases, neurologic complications were 15 of 114 (13%) overall; 7 of 22 (32%) were acute cases and 8 of 92 (9%) were chronic (p < 0.004). Early deaths for type B were 12 of 114 (11%) overall; 3 of 22 (14%) acute and 9 of 92 (10%) chronic (p < 0.6). Preoperative hypotension was significant in acute type A patients, with strokes in 2 of 7 (29%) hypotensives compared with 2 of 37 (5%) normotensives (p < 0.05) and early death in 4 of 7 (57%) hypotensives versus 5 of 37 (14%) normotensives (p < 0.009). CONCLUSIONS: Morbidity and mortality for repair of chronic dissection types A and B were acceptable. Preoperative hypotension in acute type A dissection was a major predisposing factor toward stroke (29% versus 5%, p < 0.05). Acute type B dissection had acceptable mortality (14%) but a high rate of neurologic complications (32%).
Authors:
H J Safi; C C Miller; M J Reardon; D C Iliopoulos; G V Letsou; R Espada; J C Baldwin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  66     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-09-11     Completed Date:  1998-09-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  402-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, The Methodist Hospital and Baylor College of Medicine, Houston, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting / complications,  mortality*,  surgery*
Aortic Aneurysm, Abdominal / complications,  mortality*,  surgery*
Aortic Aneurysm, Thoracic / complications,  mortality*,  surgery*
Cerebrovascular Disorders / etiology*
Child
Chronic Disease
Female
Humans
Hypotension / etiology
Male
Methods
Middle Aged
Postoperative Complications
Treatment Outcome

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


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