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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 46-59, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association


ARTICLES

Surgery for acute dissection of ascending aorta. Should the arch be included?

ES Crawford, JW Kirklin, DC Naftel, LG Svensson, JS Coselli and HJ Safi
Baylor College of Medicine, Houston, Tex.

Thirty-day and 1-, 5-, 10-, and 20-year overall survivorships among 82 patients undergoing replacement of the ascending aorta with or without the arch for acute aortic dissection between 1968 and May 1989 were 79%, 66%, 56%, 46%, and 30%, respectively. The multivariably determined risk factors for death were the inclusion of the arch in the replacement, the year of the operation, the predissection New York Heart Association functional class, diabetes, and concomitant coronary artery bypass grafting. The current 30-day survivorship predicted by the multivariable equation when the operation involves only the ascending aorta is 97%, and the 10- and 20-year predicted survivorships are 61% and 39%, respectively. When the current era the replacement involves the arch as well as the ascending aorta, the predicted 30-day survivorship is 84%, and the 10- and 20-year ones are 48% and 31%. In 1990 sixteen additional patients (one hospital death) underwent ascending aortic replacement, and six (no hospital deaths) ascending aorta and arch replacement. The predictions for 1990 from the multivariable equation were similar to these actual experiences (Ps for differences were 0.6 and 0.4). Seventy percent of surviving patients with DeBakey type I dissection were free of a second aortic operation for aneurysmal dilation of the distal false channel, but this occurred in none of nine patients in whom an intimal tear in the transverse arch was included in the resection.


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J. S MILLER, S. A LEMAIRE, and J. S COSELLI
Evaluating aortic dissection: when is coronary angiography indicated?
Heart, June 1, 2000; 83(6): 615 - 616.
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J. Thorac. Cardiovasc. Surg.Home page
J. F. Sabik, B. W. Lytle, E. H. Blackstone, P. M. McCarthy, F. D. Loop, and D. M. Cosgrove
Long-term effectiveness of operations for ascending aortic dissections
J. Thorac. Cardiovasc. Surg., May 1, 2000; 119(5): 946 - 962.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
T. Kazui, N. Washiyama, B. A. H. Muhammad, H. Terada, K. Yamashita, M. Takinami, and Y. Tamiya
EXTENDED TOTAL ARCH REPLACEMENT FOR ACUTE TYPE A AORTIC DISSECTION: EXPERIENCE WITH SEVENTY PATIENTS
J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 558 - 565.
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CirculationHome page
R. G. Leyh, C. Schmidtke, H.-H. Sievers, and M. H. Yacoub
Opening and Closing Characteristics of the Aortic Valve After Different Types of Valve-Preserving Surgery
Circulation, November 23, 1999; 100(21): 2153 - 2160.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
C. R. Smith and T. B. Spanier
Aprotinin in deep hypothermic circulatory arrest
Ann. Thorac. Surg., July 1, 1999; 68(1): 278 - 286.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
T. Konishi, K. Higuchi, M. Fukata, M. Takeda, S. Akisima, and S. Fukuda
Extended aortic replacement in acute dissection by the separated elephant trunk technique
Ann. Thorac. Surg., June 1, 1999; 67(6): 1664 - 1668.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
B. Nguyen, M. Muller, B. Kipfer, P. Berdat, B. Walpoth, U. Althaus, and T. Carrel
Different techniques of distal aortic repair in acute type A dissection: impact on late aortic morphology and reoperation
Eur J Cardiothorac Surg, April 1, 1999; 15(4): 496 - 501.
[Abstract] [Full Text] [PDF]


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ANGIOLOGYHome page
M. Demircin, R. Dogan, M. Guvener, M. Yilmaz, A. Celiker, and I. Pasaoglu
Replacement of Aortic Root with Valved Tubular Prosthesis in a Ten-Year-Old Child with Infective Endocarditis: A Case Report
Angiology, November 1, 1998; 49(11): 941 - 944.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
S. Pansini, P. V. Gagliardotto, E. Pompei, F. Parisi, G. Bardi, E. Castenetto, F. Orzan, and M. di Summa
Early and late risk factors in surgical treatment of acute type A aortic dissection
Ann. Thorac. Surg., September 1, 1998; 66(3): 779 - 784.
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J. Thorac. Cardiovasc. Surg.Home page
M. H. Yacoub, P. Gehle, V. Chandrasekaran, E. J. Birks, A. Child, and R. Radley-Smith
Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root
J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1080 - 1084.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
P. Pugliese, R. Pessotto, F. Santini, G. Montalbano, G. B. Luciani, and A. Mazzucco
Risk of late reoperations in patients with acute type A aortic dissection: impact of a more radical surgical approach
Eur J Cardiothorac Surg, May 1, 1998; 13(5): 576 - 581.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
C. Detter, H. Mair, H.-G. Klein, C. Georgescu, A. Welz, and B. Reichart
Long-term prognosis of surgically-treated aortic aneurysms and dissections in patients with and without Marfan syndrome
Eur J Cardiothorac Surg, April 1, 1998; 13(4): 416 - 423.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
F. J. Baumgartner, B. O. Omari, A. Pandya, A. Pandya, and D. M. Bethencourt
Local Transverse Arch Repair for Type A Aortic Dissection
Ann. Thorac. Surg., November 1, 1997; 64(5): 1331 - 1332.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
S. Westaby, T. Katsumata, and E. Freitas
Aortic Valve Conservation in Acute Type A Dissection
Ann. Thorac. Surg., October 1, 1997; 64(4): 1108 - 1112.
[Abstract] [Full Text]


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CirculationHome page
J. I. Fann, J. A. Smith, D. C. Miller, R. S. Mitchell, K. A. Moore, G. Grunkemeier, E. B. Stinson, P. E. Oyer, B. A. Reitz, and N. E. Shumway
Surgical Management of Aortic Dissection During a 30-Year Period
Circulation, November 1, 1995; 92(9): 113 - 121.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
L. G. Svensson, J. Sun, E. Nadolny, and W. A. Kimmel
Prospective evaluation of minimal blood use for ascending aorta and aortic arch operations
Ann. Thorac. Surg., June 1, 1995; 59(6): 1501 - 1508.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
M. Kitamura, A. Hashimoto, T. Akimoto, O. Tagusari, S. Aomi, and H. Koyanagi
Operation for type A aortic dissection: introduction of retrograde cerebral perfusion
Ann. Thorac. Surg., May 1, 1995; 59(5): 1195 - 1199.
[Abstract] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
V. L. Gott, A. M. Gillinov, R. E. Pyeritz, D. E. Cameron, B. A. Reitz, P. S. Greene, C. D. Stone, R. L. Ferris, D. E. Alejo, and V. A. McKusick
Aortic root replacementRisk factor analysis of a seventeen-year experience with 270 patients
J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 536 - 545.
[Abstract] [Full Text]


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J. Thorac. Cardiovasc. Surg.Home page
P. J. Lin, C.-H. Chang, P. P. C. Tan, C.-C. Wang, J.-P. Chang, D.-W. Liu, J.-J. Chu, K.-T. Tsai, C.-L. Kao, and M.-J. Hsieh
Protection of the brain by retrograde cerebral perfusion during circulatory arrest
J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 969 - 974.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
T. Kazui, N. Kimura, O. Yamada, and S. Komatsu
Total arch graft replacement in patients with acute type a aortic dissection
Ann. Thorac. Surg., November 1, 1994; 58(5): 1462 - 1468.
[Abstract] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
J. E. Bachet, J.-L. Termignon, G. Dreyfus, B. Goudot, L. Martinelli, A. Piquois, D. Brodaty, C. Dubois, P. Delentdecker, and D. Guilmet
Aortic dissectionPrevalence, cause, and results of late reoperations
J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 199 - 206.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
V. L. Gott
Invited commentary
Ann. Thorac. Surg., June 1, 1994; 57(6): 1674 - 1674.
[PDF]


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Ann. Thorac. Surg.Home page
M. A. Ergin, R. A. Phillips, J. D. Galla, S. L. Lansman, D. S. Mendelson, C. S. Quintana, and R. B. Griepp
Significance of distal false lumen after type A dissection repair
Ann. Thorac. Surg., April 1, 1994; 57(4): 820 - 825.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
T. Kazui, N. Kimura, O. Yamada, and S. Komatsu
Surgical outcome of aortic arch aneurysms using selective cerebral perfusion
Ann. Thorac. Surg., April 1, 1994; 57(4): 904 - 911.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
D.-W. Liu, P. J. Lin, and C.-H. Chang
Treatment of acute type a aortic dissection with intraluminal sutureless prosthesis
Ann. Thorac. Surg., April 1, 1994; 57(4): 987 - 991.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
M. Ando, N. Nakajima, S. Adachi, M. Nakaya, and Y. Kawashima
Simultaneous graft replacement of the ascending aorta and total aortic arch for type A aortic dissection
Ann. Thorac. Surg., March 1, 1994; 57(3): 669 - 676.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
S. L. Lansman, M. A. Ergin, and R. B. Griepp
Treatment of acute aortic arch dissection
Ann. Thorac. Surg., April 1, 1993; 55(4): 816 - 817.
[PDF]




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