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  • Oral presentation
  • Open Access

Result of type a dissecting aortic aneurysms surgical treatment during the 3 years (2010 - 2012)

  • 1,
  • 1Email author,
  • 1,
  • 2,
  • 3,
  • 4,
  • 1 and
  • 5
Journal of Cardiothoracic Surgery20138 (Suppl 1) :O25

https://doi.org/10.1186/1749-8090-8-S1-O25

  • Published:

Keywords

  • Aortic Aneurysm
  • Multiorgan Failure
  • Mild Hypothermia
  • Aortic Injury
  • Deep Hypothermia

Background

Present our experience of surgical treatment of type A TAAD during 2010 – 2012 - the aim of this study.

Methods

148 consecutive patients with type A TAAD were operated on during 2010 - 2012 (122 (82,4%) males). Their age ranged 20 – 77 years, mean 49,3±9,6. Acute (subacute) dissection was in 128 (86,5%), chronic – in 20 (13,5%). The causes of aneurysms forming were: arterial hypertension, atherosclerosis – in 91 (61,5%); BAV – 18 (12,2%); MS – 16 (9,8%); cystomedianecrosis – 16 (10,8%); blunt aortic injury – in 2 (1,4%) cases, unknown – 5 (3,4%); 96 (64,8%) patients had type I, others 52 (35,2%) – type II according De Bakey classification. The preoperative status included: acute aortic valve insufficiency - 64 (43,2%); haemopericardium (heart tamponade) - 26 (17,6%); acute renal insufficiency - 12 (8,1%); left ventricle failure with pulmonary edema - 5 (3,4%); multiorgan failure - 4 (2,7%) patients.

All operations were performed with bypass, mild hypothermia (26-30ºC), 42 (28,4%) patients with arch injury - deep hypothermia (18-20ºC) and retrograde cerebral perfusion.

We used: supracoronary grafting with valve resuspension- in 98 (66,2%) pts, Bentall-de Bono operation in 48 (32,4%); David operation in 2 (1,4%).

Results

Mean blood loss after operation was 519±82,7 ml. Hemorrhage became the reoperation reason in 5 (3,4%) pts. Temporary neurological complications were observed in 7 (4,7%) pts. There were no difference in deep and mild hypothermia group. Permanent neurological complications were absent. The postoperative 30 days mortality composed 4,7% (7 patients). All lethal events occurred in the acute dissection group. The reasons of lethal events were: acute renal failure – in 4 (2,7 %) patients, hemorragie – in 1(0,7%) patients, multiorgan failure – in 2 (1,3%).

Conclusion

Obtained surgical experience, improvement of heart and brain protection in surgical treatment of dissecting aneurysms type A permitted to achieve hospital mortality 4,7%.

Authors’ Affiliations

(1)
Department of Surgical Treatment of Aortic Pathology, National M. Amosov ICVS NAMS of Ukraine, Kyiv, Ukraine
(2)
Department of Anaestesiology, National M. Amosov ICVS NAMS of Ukraine, Kyiv, Ukraine
(3)
ICU of Department Surgical Treatment of Aortic Pathology, National M. Amosov ICVS NAMS of Ukraine, Kyiv, Ukraine
(4)
Scientific Secretariat, National M. Amosov ICVS NAMS of Ukraine, Kyiv, Ukraine
(5)
Director of National M. Amosov ICVS NAMS of Ukraine, Kyiv, Ukraine

Copyright

© Kravchenko et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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