| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2002;123:318-325
© 2002 The American Association for Thoracic Surgery
Surgery for Acquired Cardiovascular Disease (ACD) |
From the Service de Chirurgie Thoracique et Cardiovasculaire, Hôpital Henri Mondor, Créteil, France.
Received for publication May 8, 2001. Revisions requested June 25, 2001; revisions received Aug 2, 2001. Accepted for publication Aug 9, 2001. Address for reprints: Matthias Kirsch, MD, Hôpital Henri Mondor, Service de Chirurgie Thoracique et Cardiovasculaire, 51, avenue du Mal de Lattre de Tassigny, 94010 Créteil Cédex, France (E-mail: loisance{at}univ-paris12.fr).
Objective: This study was undertaken to determine significant risk factors for proximal or distal reoperations after surgical correction of acute type A aortic dissection.
Methods: Between 1980 and 2000, a total of 160 consecutive patients (mean age 57.5 ± 13.3 years, 126 men) underwent surgery for acute type A aortic dissection. Proximal repair was performed by means of ascending aorta replacement with valve resuspension in 130 cases (81.3%), composite graft replacement in 19 cases (11.9%), separate aortic valve and ascending aorta replacement in 7 cases (4.4%), and aortic repair in 1 case (0.6%). Distal repair required arch replacement in 23 cases. Follow-up time averaged 4.51 ± 5.6 years per patient.
Results: Survival estimates after initial operation were 66.1% ± 3.8%, 57.7% ± 4.2%, 52.2% ± 4.6%, and 42.5% ± 5.8% at 1, 5, 10, and 15 years, respectively. Thirty patients required 37 reoperations at a mean interval of 5.7 ± 4.5 years after the initial operation. Freedoms from reoperation were 96.9% ± 1.8%, 74.7% ± 5.3%, 60.8% ± 6.8%, and 39.3% ± 9.1% at 1, 5, 10, and 15 years, respectively. Reoperations included procedures on the proximal aorta (aortic root or valve) in 21 cases and on the distal aorta or its side branches in 19 cases. Cox regression analysis distinguished severe preoperative aortic valve insufficiency as the only significant risk factors for proximal reoperation; younger patient age, more distal extent of dissection, and more recent operative date were found to be significant risk factors for distal reoperation.
Conclusion: Patients with acute type A aortic dissection who have severe aortic valve insufficiency are at increased risk for proximal reoperation. These patients should benefit from a more aggressive proximal repair at initial operation. Distal extent of aortic resection at initial operation did not significantly influence the risk of distal reoperation.
Related Article
J. Thorac. Cardiovasc. Surg. 2002 123: 201-203.
This article has been cited by other articles:
|
|
 |
|
  K.-H. Park, C. Lim, J. H. Choi, E. Chung, S. I. Choi, E. J. Chun, and K. Sung Midterm Change of Descending Aortic False Lumen After Repair of Acute Type I Dissection Ann. Thorac. Surg., January 1, 2009; 87(1): 103 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Kimura, M. Tanaka, K. Kawahito, A. Yamaguchi, T. Ino, and H. Adachi Influence of patent false lumen on long-term outcome after surgery for acute type A aortic dissection. J. Thorac. Cardiovasc. Surg., November 1, 2008; 136(5): 1160 - 1166.e3. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Jakob, K. Tsagakis, P. Tossios, P. Massoudy, M. Thielmann, T. Buck, H. Eggebrecht, and M. Kamler Combining Classic Surgery With Descending Stent Grafting for Acute DeBakey Type I Dissection. Ann. Thorac. Surg., July 1, 2008; 86(1): 95 - 101. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Karck and H. Kamiya Progress of the treatment for extended aortic aneurysms; is the frozen elephant trunk technique the next standard in the treatment of complex aortic disease including the arch? Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1007 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-J. Schafers and T. Kunihara Towards safer reoperations: special aspects in aortic dissection Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 700 - 702. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Geirsson, J. E. Bavaria, D. Swarr, M. G. Keane, Y. J. Woo, W. Y. Szeto, and A. Pochettino Fate of the Residual Distal and Proximal Aorta After Acute Type A Dissection Repair Using a Contemporary Surgical Reconstruction Algorithm Ann. Thorac. Surg., December 1, 2007; 84(6): 1955 - 1964. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Watanuki, H. Ogino, K. Minatoya, H. Matsuda, H. Sasaki, M. Ando, and S. Kitamura Is Emergency Total Arch Replacement With a Modified Elephant Trunk Technique Justified for Acute Type A Aortic Dissection? Ann. Thorac. Surg., November 1, 2007; 84(5): 1585 - 1591. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Zierer, R. K. Voeller, K. E. Hill, N. T. Kouchoukos, R. J. Damiano Jr, and M. R. Moon Aortic Enlargement and Late Reoperation After Repair of Acute Type A Aortic Dissection Ann. Thorac. Surg., August 1, 2007; 84(2): 479 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Geirsson, W. Y. Szeto, A. Pochettino, M. L. McGarvey, M. G. Keane, Y. J. Woo, J. G. Augoustides, and J. E. Bavaria Significance of malperfusion syndromes prior to contemporary surgical repair for acute type A dissection: outcomes and need for additional revascularizations Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 255 - 262. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Olsson, N. Eriksson, E. Stahle, and S. Thelin Surgical and long-term mortality in 2634 consecutive patients operated on the proximal thoracic aorta Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 963 - 969. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Zierer, M. R. Moon, S. J. Melby, N. Moazami, J. S. Lawton, N. T. Kouchoukos, M. K. Pasque, and R. J. Damiano Jr Impact of Perfusion Strategy on Neurologic Recovery in Acute Type A Aortic Dissection Ann. Thorac. Surg., June 1, 2007; 83(6): 2122 - 2129. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Estrera, C. C. Miller III, M. A. Villa, T.-Y. Lee, R. Meada, A. Irani, A. Azizzadeh, S. Coogan, and H. J. Safi Proximal Reoperations After Repaired Acute Type A Aortic Dissection Ann. Thorac. Surg., May 1, 2007; 83(5): 1603 - 1609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Nakajima, K. Kawazoe, T. Kataoka, H. Kin, T. Kazui, H. Okabayashi, and H. Niinuma Midterm Results of Aortic Repair Using a Fabric Neomedia and Fibrin Glue for Type A Acute Aortic Dissection Ann. Thorac. Surg., May 1, 2007; 83(5): 1615 - 1620. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Gariboldi, D. Grisoli, F. Kerbaul, R. Giorgi, A. Riberi, D. Metras, T. G. Mesana, and F. Collart Long-term outcomes after repaired acute type A aortic dissections Interactive CardioVascular and Thoracic Surgery, February 1, 2007; 6(1): 47 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Farhat, M. Durand, L. Boussel, I. Sanchez, J. Villard, and O. Jegaden Should a reimplantation valve sparing procedure be done systematically in type A aortic dissection? Eur. J. Cardiothorac. Surg., January 1, 2007; 31(1): 36 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Halstead, M. Meier, C. Etz, D. Spielvogel, C. Bodian, M. Wurm, R. Shahani, and R. B. Griepp The fate of the distal aorta after repair of acute type A aortic dissection J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 127 - 135. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Olsson, S. Thelin, E. Stahle, A. Ekbom, and F. Granath Thoracic Aortic Aneurysm and Dissection: Increasing Prevalence and Improved Outcomes Reported in a Nationwide Population-Based Study of More Than 14 000 Cases From 1987 to 2002 Circulation, December 12, 2006; 114(24): 2611 - 2618. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Narayan, C. A Rogers, M. Caputo, G. D Angelini, and A. J Bryan Ascending Aorta or Arch Surgery: Is Previous Cardiac Surgery a Risk Factor? Asian Cardiovasc Thorac Ann, February 1, 2006; 14(1): 14 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Ochiai, Y. Imoto, M. Sakamoto, Y. Ueno, T. Sano, H. Baba, and A. Sese Long-Term Effectiveness of Total Arch Replacement for Type A Aortic Dissection Ann. Thorac. Surg., October 1, 2005; 80(4): 1297 - 1302. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Halstead, D. Spielvogel, D. M. Meier, S. Rinke, C. Bodian, R. Malekan, M. A. Ergin, and R. B. Griepp Composite aortic root replacement in acute type A dissection: time to rethink the indications? Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 626 - 632. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Hirose, L. G. Svensson, B. W. Lytle, E. H. Blackstone, J. Rajeswaran, and D. M. Cosgrove Aortic Dissection After Previous Cardiovascular Surgery Ann. Thorac. Surg., December 1, 2004; 78(6): 2099 - 2105. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A Beckman, R. H Mehta, E. M Isselbacher, E. Bossone, J. V Cooper, D. E Smith, J. Fang, U. Sechtem, L. A Pape, T. Myrmel, et al. Branch vessel complications are increased in aortic dissection patients with renal insufficiency Vascular Medicine, November 1, 2004; 9(4): 267 - 270. [Abstract] [PDF]
|
|
|
|
|
|
T. Hirotani, T. Nakamichi, M. Munakata, and S. Takeuchi Routine extended graft replacement for an acute type a aortic dissection and the patency of the residual false channel Ann. Thorac. Surg., December 1, 2003; 76(6): 1957 - 1961. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. T. Lai, D. C. Miller, R. S. Mitchell, P. E. Oyer, K. A. Moore, R. C. Robbins, N. E. Shumway, and B. A. Reitz Acute type a aortic dissection complicated by aortic regurgitation: composite valve graft versus separate valve graft versus conservative valve repair J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1978 - 1985. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. S. H. Tan, K. M. E. Dossche, W. J. Morshuis, J. C. Kelder, F. G. J. Waanders, and M. A.A.M. Schepens Is extended arch replacement for acute Type A aortic dissection an additional risk factor for mortality? Ann. Thorac. Surg., October 1, 2003; 76(4): 1209 - 1214. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Long, C. G. Tribble, D. P. Raymond, S. M. Fiser, A. K. Kaza, J. A. Kern, and I. L. Kron Preoperative shock determines outcome for acute type A aortic dissection Ann. Thorac. Surg., February 1, 2003; 75(2): 520 - 524. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Elefteriades What operation for acute type a dissection? J. Thorac. Cardiovasc. Surg., February 1, 2002; 123(2): 201 - 203. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
