| 摘要 |
Objectives: This study reports our surgical results for aortic dissection and the post-operative follow up. Possible reasons for post-operative cerebral insults are discussed.
Methods: From October 2000 to April 2004, 23 patients (18 men; 5 women; mean age 54.8 ± 15.8 years) underwent operation for aortic dissection in our hospital. According to the Standford classification, there were 19 cases in Type A and 4 cases in Type B. Five patients had surgery under profound hypothermic circulatory arrest with retrograde perfusion. Surgical strategies included aortic grafting only (9/23, 39.1%), aortic valve replacement with supracoronary ascending aortic grafting (1/23, 4.3%), aortic valve replacement with supracoronary ascending aortic grafting (6/23, 26.1%), aortic valve replacement with supracoronary ascending aortic grafting and coronary artery bypass hrafting (2/23, 8.7%), Bentall operation (3/23, 13.0%) and Bentall operation with coronary artery bypass grafting (2/23,8.7%).
Results: There was no operative or in-hospital mortality. Median ventilator supporting time was 4 days (range:1 to 94). Re-exploration for hemostasis was needed in 2 patients, Cerebral ischemic infarction was found in 3 patients. All the patients received post-operative follow up. Mean follow-up time was 20.7 ± 14.2 months (range:2 to 40). All the patients had clear consciousness during the follow up. There were 5 late deaths. Both the one-year and two-year survival rates were 78.9%, and the three-year survival rate was 70.1%.
Conclusion:Aortic dissection is a challenge for cardiovascular surgeons. However, good results and acceptable morbidities can be achieved under profound hypothermic circulatory arrest with retrograde perfusion. |
