SURGICAL-TREATMENT OF CHRONIC AORTIC DISSECTIONS

被引：7

作者：

GANDJBAKHCH, I

JAULT, F

VAISSIER, E

LEVASSEUR, JP

PAVIE, A

PETRIE, J

BORS, V

CABROL, C

机构：

[1] Department of Cardiovascular Surgery, Pitie's Hospital, Paris

[2] Service de Chirurgie Cardiovasculaire, Hôpital de la Pitié, 83 boulevard de L'Hôpital, Paris

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1990年 / 4卷 / 09期

关键词：

D O I：

10.1016/1010-7940(90)90167-X

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Between January 1976 and March 1987, 78 patients underwent surgery for chronic aortic dissection at our institution. The ascending aorta was involved in 66 cases (Stanford type A) and was not involved in 12 cases (Stanford type B), wherever the initial dissection was suspected. Aortography remains the main preoperative investigation. The surgical technique varies according to the type of dissection. It seems essential to exclude the primary intimal tear and all dilated segments of the aorta must be replaced. The overall operative mortality was 11.5% (7.5% in type A, 33.3% in type B dissection). Sixty-three patients have been followed for a period varying between 6 months and 10 years (mean 5 years). The overall survival at 6 years is 60% ± 5.6%. Because of the ultimate risk of aneurysmal dilatation of the false channel, these patients must be followed by CT scanning, colour flow Doppler echocardiography, magnetic resonance imaging, and in some cases, aortography. © Springer-Verlag.

引用

页码：466 / 471

页数：6

共 19 条

[1]

Cabrol C., Gandjbjakhch I., Pavie A., Long term results with total replacement of the ascending aorta and reimplantation of coronary arteries, J Thorac Cardiovasc Surg, 91, pp. 17-25, (1986)

[2]

Carpentier A., Deloche A., Fabiani J.N., Chauvaud S., Relland J., Nottin R., Vouhe P., Massoud H., Dubost C., New surgical approach to aortic dissection: flow reversal and thrombo exclusion, J Thorac Cardiovasc Surg, 81, pp. 659-668, (1981)

[3]

Cooke J.P., Safford R.E., Progress in the diagnosis and management of aortic dissections, Mayo Clinic Proc, 61, pp. 147-153, (1986)

[4]

Crawford E.S., Crawford J.L., Stowe C.L., Safi H.J., Total aortic replacement for chronic aortic dissection occuring in patients with and without Marfan syndrome, Ann Surg, 199, pp. 358-362, (1984)

[5]

Crawford E.S., Mizrahi E.M., Hess R.P., Caselli J.S., Safi H.J., Patel U.M., The impact of distal aortic perfusion and somatosensory evoked potential monitoring on prevention of paraplegia after aortic aneurysm operation, J Thorac Cardiovasc Surg, 95, pp. 357-367, (1988)

[6]

DeBakey M.E., Collum C.H., Crawford E.S., Morris C.C., Howell J., Noon J.P., Lawrie G., Dissection and dissecting aneurysms of the aorta: twenty year follow up of five hundred twenty seven patients treated surgically, Surgery, 92, pp. 1118-1134, (1982)

[7]

DeSanctis R.W., Doroghazi R.M., Austen G.W., Buckley M.J., Aortic dissection, N Engl J Med, 17, pp. 1060-1067, (1987)

[8]

Doroghazi R.M., Slater E.E., Desanctis R.W., Buckley M.J., Austen G.W., Rosenthal S., Long term survival of patients with treated aortic dissection, J Am Coll Cardiol, 3, pp. 1026-1034, (1984)

[9]

Fukuda T., Tadavarthy S.M., Edwards J., Dissecting aneurysm of aorta complicating aortic valvular stenosis, Circulation, 53, pp. 1699-175, (1976)

[10]

Goldman A.P., Kotler M.N., Scanlon M.H., Ostrum B., Parameswaran P., Parry W.R., The complementary role of magnetic resonance imaging, Doppler echocardiography, and computed tomography in the diagnosis of dissecting thoracic aneurysms, Am Heart J, 111, pp. 970-981, (1986)

← 1 2 →