Suprakomissural Aort Replasmanı: Akut ve Kronik Tip A Aort Disseksiyonu İçin Güvenilir Bir Seçenek

Abstract

Objective: To review early and late results of supracommissural aortic replacement in patients with acute and chronic type A dissection. Material and Methods: From February 1985 to October 2005, 162 patients with acute and chronic aortic dissection underwent supracommissural aortic graft replacement. A retrospective clinical review was undertaken using hospital records, clinical and echocardiographic data, and telephone interviews with patients. Results: There were 23 (14.1 %) operative and eight (6.4 %) late deaths. The most common causes of hospital death were intraoperative complications related to hemorrhage (n= 9), and respiratory failure (n = 6), and the other cause was multiorgan failure (n= 5). The hospital mortality rate for patients with chronic type A dissection was 6.25% (3/48). The causes of death were respiratory failure (n= 2) and multiorgan failure (n= 1). The modes of hospital deaths were not related to residual aortic insufficiency (AR) in any case since early postoperative transthoracic echocardiography did not show grater than grade II in these patients in early postoperative or follow-up period, transthoracic echocardiography did not show aortic regurgitation grater than grade II in any case. All survivors were in New York Heart Association class I or II at the last visit. Conclusion: Supracommissural aortic graft replacement provides satisfactory results for many patients with ascending aortic dissection. The function of the preserved aortic valves remained unchanged in the majority of the patients during the first five years of follow-up.