| Ten years of surgery of aortic dissections and aneurysms. Clinical experience and original contributions. | |
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MedLine Citation:
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PMID: 1291923 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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From January '82 to April '91, 117 patients with aortic disease were operated upon at our University Hospital in Genoa, Italy. Thirty-seven had arch dissections or aneurysms; 66 had acute aortic dissection type A and 14 had aortic dissections or aneurysms type B, acute and chronic. Patients with arch or type B aortic pathology but without surgical indication and cases of post-traumatic aortic transections are not included. There were 84 male and 33 female patients with a mean age of 52 (6 min and 74 max). In the acute patients, the mean interval between clinical onset and surgery was 34 hours (6 min-72 max). All patients with primary arch disease had surgical repair with the aid of deep hypothermia and circulatory arrest (17-96 min). Type A dissections were treated with standard CPBP at 28 degrees C. Surgical techniques included direct suture of intimal tear alone, direct suturing of the two aortic stumps; interposition of Dacron tubular prosthesis; Bentall repair; separated valve and aortic replacement; an original aortic bulb aortoplasty with valve repair; arch replacement with resuturing of one or more aortic trunks. Human fibrin glue (Tissucol) was employed either as haemostatic agent, widely spread over the suture lines or as tissue adhesion agent between dissected aortic layers. Human fibrin glue is adopted because it gathers high glueing capacity and maintenance of the elastic property of the vessel wall. Hospital mortality (30 days) has been 25% in ascending aortic dissections (16/66 patients) and 50% in patients with arch disease (18/37 patients) who needed circulatory arrest. Late mortality 5/83 (6%). Reoperations for aortic valve insufficiency or re-dissection have been 7 (8.4%). Early diagnosis (increasing reliability of 2D-Echo and CT scans), aggressive surgery, meticulous myocardial and cerebral protection and introduction in clinical use of biological glues seem to be the milestones of present and further improvements in surgical results. |
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Authors:
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V Dottori; S Spagnolo; G Passerone; A Lijoi; L Barberis; M Agostini; G De Gaetano; E Parodi; M Maccario; C Fumagalli |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Minerva cardioangiologica Volume: 40 ISSN: 0026-4725 ISO Abbreviation: Minerva Cardioangiol Publication Date: 1992 Nov |
Date Detail:
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Created Date: 1993-03-29 Completed Date: 1993-03-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0400725 Medline TA: Minerva Cardioangiol Country: ITALY |
Other Details:
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Languages: eng Pagination: 431-6 Citation Subset: IM |
Affiliation:
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Cattedra e Divisione di Cardiochirurgia, Università degli Studi-Ospedale San Martino, Genova. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Adult Aged Anastomosis, Surgical Aneurysm, Dissecting / surgery* Aorta / surgery Aortic Aneurysm, Abdominal / surgery* Aortic Aneurysm, Thoracic / surgery* Child Chronic Disease Female Femoral Artery / surgery Humans Male Middle Aged |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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