Clinical Analysis of Surgery for Aortic Disease

대동맥 질환 수술의 임상적 고찰

  • Published : 1995.10.01

Abstract

From January 1991 to January 1995, 11 patients with aortic diseases underwent various surgical repairs. The age at operation ranged from 26 years to 63 years[ mean=50.9 years . The disease entities included 8 aortic dissections[ type I in 4, type II in 2 and type III in 2 cases , 2 Marfan`s syndrome with annuloaortic ectasia and 1 desecending thoracic aortic aneurysm The operative procedures we tried were 3 Bentall`s operation, 5 graft replacement of ascending aorta, and 3 graft interposition in descending thoracic aorta.Overall hospital mortality rate is 36.3%[4/11 . And causes of death are pump weaning failure in 2 cases and multiorgan failure in 2 cases. It was that 2 sternal dehiscence & mediastinitis, 1 acute renal failure, 2 hypoxic brain damages and 2 postoperative psychosis were complicated. Recently we tried surgical repair of aortic dissection five out of 6 cases using total circulatory arrest with deep hypothermia at 14$^{\circ}C$. Total circulatory arrest time ranged from 18 to 26 minutes[ mean 22.2 minutes , and mean aortic cross-clamping time was 48.2 minutes. One of 5 patient died on the 7th postoperative day due to multiorgan failure. Mortality of patients with TCA was 20%[1/5 , and it of remainders was 50%[3/6 . Our result for surgical repair using total circulatory arrest with deep hypothermia is satisfactory on the basis of our clinical data.

Keywords

References

  1. JAMA v.264 The diagnosis and management of aortic dissection Crawford,E.S.
  2. 대흉외지 v.27 Surgical treatment of the involving ascending aorta Back,W.K.;Kim,H.;Suh,P.W.(et al.)
  3. Am J Cardiol v.39 Pathogenesis of dissecting aneurysm of aorta Schlatmann,T.J.;Becker,A.E.
  4. J Thorac Cardivasc Surg v.108 Rapid noninvasive diagnosis and surgical repair of acute ascending aortic dissection Rizzo,R.J.;Aranki,S.F.;Aklog,L.(et al.)
  5. N Engl J Med v.328 The diagnosis of thoracic aortic dissection by noninvasive imaging procedures Nienaber,C.A.;vonKodolitsch,Y.;Nicolas,V.(et al.)
  6. Ann Surg v.132 Hypothermia-its possible role in cardiac surgery : an investigation of factors governing survival in dogs at low body temperature Bigelow,W.G.;Lindsay,W.K.
  7. J Thorac Cardiovasc Surg v.48 Arteriovenous fissula of the aortic arch : Repair during deep hypothermia and circulatory arrest Borst,H.G.;Schanding,A.;Rudolph,W.
  8. 대흉외지 v.25 대동맥류 수술시의 초저체온법 및 완전순환 차단에 관한 임상고찰 백완기;안혁
  9. J Thorac Cardiovasc Surg v.80 Results of composite graft replacement for aortic root aneurysms Helseth,H.K.;Haglin,J.J.;Monson,B.K.;Wickstrom,P.H.
  10. J Thorac Cardiovasc Surg v.76 Mayer,J.E.;Lindsay,W.G.;Wang,Y.;Jorgensen,C.R.;Nicoloff,D.M.
  11. Ann Thorac Surg v.58 New composite graft repair for patients with and without Marfan's syndrome Suzuki,A.;Amano,J.;Sunamori,M.;Sakamoto,T.;Tanaka,H.
  12. 대흉외지 v.26 대동맥판부전이 동반된 상행대동맥류의 외과적 치험 박만실;장병철;강면식;조범구;홍승록
  13. 대흉외지 v.27 해리성 대동맥류 58예에 대한 임상적 고찰 정철하;박현;구본일(등)