Clinical Outcome of Emergency Surgery for Complicated Acute Type B Aortic Dissection

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著者

    • MURASHITA Takashi
    • Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital
    • OGINO Hitoshi
    • Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
    • MATSUDA Hitoshi
    • Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
    • SASAKI Hiroaki
    • Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
    • TANAKA Hiroshi
    • Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
    • IBA Yutaka
    • Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
    • DOMAE Keitaro
    • Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
    • FUJIWARA Tatsuki
    • Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center

抄録

<b><i>Background:</i></b> The aim of the present study was to review the clinical profile and outcome of emergency surgery for complicated acute type B aortic dissection. <b><i>Methods and Results:</i></b> A total of 34 consecutive patients requiring surgical treatment for complicated acute type B aortic dissection between 2003 and 2010 were examined. The median age was 64.0 years (range, 19-82 years). Indication for emergency surgery was aortic rupture in 11 patients, rapid expansion of the dissecting aorta in 5, dissection involving a non-dissecting aneurysm in 6, and organ malperfusion in 12. All of 3 patients with open aortic rupture died during surgery. Operative mortality was 9.7% (central operation, 14.2%; peripheral operation, 7.1%; thoracic endovascular aneurysm repair, 0%). There were 2 aortic ruptures within 1 week after operation. Two patients suffered from persistent organ malperfusion after emergency surgical relief of ischemia and died. The 1- and 5-year survival rates were 74.1±8.1% and 64.8±11.2%. The actual rate of freedom from aortic events at 1- and 5- years was 83.0±7.0% and 58.7±11.4%. <b><i>Conclusions:</i></b> Emergency surgery for complicated acute type B dissection still has a high mortality rate for patients with open rupture and critical visceral ischemia. Medical treatment is best given immediately after admission, and adequate surgical treatment without delay is crucial. (<i>Circ J</i> 2012; <b>76:</b> 650-654)<br>

収録刊行物

  • Circulation journal : official journal of the Japanese Circulation Society

    Circulation journal : official journal of the Japanese Circulation Society 76(3), 650-654, 2012-02-25

    The Japanese Circulation Society

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各種コード

  • NII論文ID(NAID)
    10030130016
  • NII書誌ID(NCID)
    AA11591968
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    13469843
  • データ提供元
    CJP書誌  J-STAGE 
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