Document Detail

Surgical strategies for organ malperfusions in acute type B aortic dissection.
MedLine Citation:
PMID:  18854338     Owner:  NLM     Status:  MEDLINE    
This study is retrospectively to evaluate strategies for organ malperfusion on the view point of two mechanisms (true lumen collapse in the aorta=Ao type, or branch dissection=Br type) in acute type B aortic dissection. There were 16 of Ao type and 4 of Br type in 20 patients with organ malperfusion. In Ao type, we performed entry closure in 12 patients, surgical bypass grafting in two to superior mesenteric artery (SMA) in one and femoral artery in two, and surgical fenestration in two. In Br type, we performed interventional non-covered stenting to the orifice of visceral arteries in two patients, surgical bypass to SMA with ileum resection in one, and surgical bypass to SAM and renal arteries in one. Five patients in 16 of Ao type died within 30 days that had two multiple organ failure after entry closure, one aortic injury during endovascular stent graft repair, two more multiple organ failure after femoral bypass, however, all four patients in Br type were rescued. Central aortic operation to true lumen collapse with entry closure for Ao type ischemia and organ reperfusion with extra-anatomical bypass or non-covered stent to ischemic arteries for Br type ischemia should be performed before catastrophic status.
Naomichi Uchida; Hidenori Shibamura; Akira Katayama; Keishi Aishin; Miwa Sutoh; Masatsugu Kuraoka
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Publication Detail:
Type:  Journal Article     Date:  2008-10-14
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  8     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  75-8     Citation Subset:  IM    
Division of Cardiovascular Surgery, Hiroshima-city Asa General Hospital, Hiroshima, Japan.
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MeSH Terms
Acute Disease
Aged, 80 and over
Aneurysm, Dissecting / complications,  mortality,  radiography,  surgery*
Aortic Aneurysm / complications,  mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Femoral Artery / surgery
Ischemia / etiology,  mortality,  radiography,  surgery*
Mesenteric Artery, Superior / surgery
Middle Aged
Multiple Organ Failure / etiology,  surgery
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures* / adverse effects,  instrumentation,  mortality

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

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