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J Cardiothorac Surg. 2013 Apr 11;8:78. doi: 10.1186/1749-8090-8-78.

Surgical management for acute type A aortic dissection in patients over 70 years-old.

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1
Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

BACKGROUND:

This study aimed to retrospectively investigate our experience of surgical treatment for acute type A aortic dissection in patients older than 70 years.

METHODS:

From September 2005 to January 2012, eleven patients who were older than 70 years underwent surgical treatment for type A aortic dissection at our center and were included in this study. Total arch replacement was performed in three patients, seven patients underwent subtotal arch replacement and one with single-branched stent graft implantation. One patient underwent a valve-sparing (David) procedure while another underwent a concomitant aortic valve replacement (Wheat procedure). One patient required coronary artery bypass grafting. All operations were performed under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion.

RESULTS:

There was one in-hospital death (9.1%) and no operative mortality within 30 days. Cardiopulmonary bypass time, myocardial ischemic time and antegrade cerebral perfusion time accounted for 151.4 ± 33.5 minutes, 68.5 ± 41.4 minutes and 30.3 ± 12.9 minutes, respectively. Overall in-hospital duration, intensive care unit (ICU) time and mean ventilation time were 40.9 ± 40.3 days, 16.5 ± 22.5 days and 90.5 ± 139.4 hours, respectively. New postoperative permanent neurological dysfunction and temporary neurological dysfunction were observed in one patient (9.1%) and in three patients (27.3%), respectively. Mean follow-up was 49.0 ± 19.9 months and nine patients are still alive, one patient died of cancer after 24 months postoperation.

CONCLUSIONS:

Surgical management for acute type A dissection in patients older than 70 years is a safe alternative with acceptable risk of death and the early and late results are satisfactory.

PMID:
23577777
PMCID:
PMC3639068
DOI:
10.1186/1749-8090-8-78
[Indexed for MEDLINE]
Free PMC Article
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