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Acute Type A Aortic Dissection. Influence of Early Management on Results

Department of Surgery Aortic Surgery Centre Cairo University Cairo, Egypt 1 Department of Cardiovascular Surgery Naser Institute Cairo, Egypt
For reprint information contact: Najib Al-Khaja, MD, PhD Tel: 971 4 271 4444 Fax: 971 4 271 9340 email: drnajib{at}emirates.net.ae Department of Cardiothoracic Surgery, Dubai Hospital, P.O. Box 7272, Dubai, UAE.

One hundred and six patients were operated upon for acute type A aortic dissection in 7 years between February 1992 and May 1999. There were 102 males and 4 females, aged 18 to 83 years with a mean of 59 ± 14 years. All patients underwent surgery within 14 hours of diagnosis. The ascending aorta was replaced with a Dacron graft in 103 patients; in the other 3 cases, the repair extended to the aortic arch. The aortic valve was preserved by resuspension in all except 4 patients, 3 of whom had Marfan's syndrome. There were 9 (8.5%) deaths, all due to respiratory and multiorgan failure. Nine patients (8.5%) needed hemodialysis; only one of these required permanent dialysis. Ten patients (9.4%) had transient neurological disorders, 2 others (1.9%) suffered permanent hemiplegia. Three patients (2.8%) underwent reoperation for bleeding. Tracheostomy for prolonged respiratory assistance was required in 6 patients (5.7%), of whom 1 died from respiratory failure. Early surgical intervention could be performed with low morbidity and mortality.