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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
ES Crawford, JW Kirklin, DC Naftel, LG Svensson, JS Coselli and HJ Safi
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.
ARTICLES
Surgery for acute dissection of ascending aorta. Should the arch be included?
Baylor College of Medicine, Houston, Tex.
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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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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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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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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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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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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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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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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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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. 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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V. L. Gott Invited commentary Ann. Thorac. Surg., June 1, 1994; 57(6): 1674 - 1674. [PDF] |
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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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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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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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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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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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