ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Yoshiharu Takahara
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Takahara, Y.
Right arrow Articles by Sakurai, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Takahara, Y.
Right arrow Articles by Sakurai, M.
Related Collections
Right arrow Great vessels

Ann Thorac Surg 2002;73:450-454
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Total aortic arch grafting for acute type A dissection: analysis of residual false lumen

Yoshiharu Takahara, MD*a, Yoshio Sudo, MDa, Kenzi Mogi, MDa, Mituyuki Nakayama, MDa, Manabu Sakurai, MDa

a Division of Cardiovascular Surgery, Funabashi Municipal Medical Center, Funabashi, Japan

Accepted for publication October 16, 2001.

* Address reprint requests to Dr Takahara, Division of Cardiovascular Surgery, Funabashi Municipal Medical Center, 1-21-1, Kanasugi, Funabashi, Chiba, Japan 273-8588
e-mail: yosh193{at}attglobal.net

Background. In surgery for acute type A dissection, an unresected dissection and residual false lumina are causes of the progression of aneurysms and ruptures. We grafted the ascending aorta and total arch, the maximum grafting possible through a median sternotomy alone, in all patients with type A dissection extending to the descending aorta, wherever initial tears existed in the arch.

Methods. A total of 37 consecutive patients with acute type A dissection underwent ascending and total arch grafting between August 1994 and December 2000. Cerebral protection was achieved by selective cerebral perfusion. The distal anastomosis was conducted using the "Elephant Trunk" technique. Patent false lumina were evaluated using computed tomography 3 months after the operation.

Results. The hospital mortality was 8.1%. No major cerebral complications were observed. The incidence of residual thoracic patent false lumina was 26.5%. Univariate analyses showed Marfan syndrome and preoperative extension of false lumina to be statistically significant determinants of residual thoracic false lumina. On multivariate analysis, no other significant independent predictor of residual false lumina in the thoracic aorta was found.

Conclusions. Outcomes of our strategy were satisfactory. However, residual thoracic false lumina could not be prevented in 26.5% of the patients. Thus, this extended operation is indicated in patients with initial tears in the aortic arch or distal arch, those with Marfan syndrome, and young patients with preoperative patent false lumina extending to the abdominal aorta.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
M. Karck and H. Kamiya
Progress of the treatment for extended aortic aneurysms; is the frozen elephant trunk technique the next standard in the treatment of complex aortic disease including the arch?
Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1007 - 1013.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
Y. Ochiai, Y. Imoto, M. Sakamoto, Y. Ueno, T. Sano, H. Baba, and A. Sese
Long-Term Effectiveness of Total Arch Replacement for Type A Aortic Dissection
Ann. Thorac. Surg., October 1, 2005; 80(4): 1297 - 1302.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
K. Kirali, H. Ardal, V. Erentug, D. Mansuroglu, N. U Bozbuga, and C. Yakut
Surgical Outcome of Subtypes of Aortic Arch Dissection
Asian Cardiovasc Thorac Ann, December 1, 2004; 12(4): 300 - 305.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Hirotani, T. Nakamichi, M. Munakata, and S. Takeuchi
Routine extended graft replacement for an acute type a aortic dissection and the patency of the residual false channel
Ann. Thorac. Surg., December 1, 2003; 76(6): 1957 - 1961.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K. Kawahito, H. Adachi, S.-i. Murata, A. Yamaguchi, and T. Ino
Coronary malperfusion due to type a aortic dissection: mechanism and surgical management
Ann. Thorac. Surg., November 1, 2003; 76(5): 1471 - 1476.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. E. S. H. Tan, K. M. E. Dossche, W. J. Morshuis, J. C. Kelder, F. G. J. Waanders, and M. A.A.M. Schepens
Is extended arch replacement for acute Type A aortic dissection an additional risk factor for mortality?
Ann. Thorac. Surg., October 1, 2003; 76(4): 1209 - 1214.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. Ohtsubo, T. Itoh, K. Takarabe, K. Rikitake, K. Furukawa, H. Suda, and Y. Okazaki
Surgical results of hemiarch replacement for acute type A dissection
Ann. Thorac. Surg., November 1, 2002; 74(5): S1853 - 1856.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Mizuno, M. Toyama, N. Tabuchi, H. Wu, and M. Sunamori
Stented elephant trunk procedure combined with ascending aorta and arch replacement for acute type A aortic dissection
Eur. J. Cardiothorac. Surg., October 1, 2002; 22(4): 504 - 509.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2002 by The Society of Thoracic Surgeons.