Surgical treatment of thoracic aortic dissecting aneurysm: A report of 115 cases / 医学研究生学报

Objective: The present study aims to summarize the clinical experience in the surgical treatment of thoracic aortic dissecting aneurysm.Methods: We retrospectively analyzed the clinical data of 115 cases of thoracic aortic dissecting aneurysm treated by surgery from December 1995 to December 2006.Thirty-eight of them were DeBakey type I aortic dissection,18 type Ⅱ,and 59 type Ⅲ.Of the 38 DeBakey type I patients,30 underwent ascending aorta with total aortic arch replacement(2 cases of total thoracic aortic artificial vessel replacement,25 Wheat procedure and 3 aortic valvuloplasty) and the other 8 received ascending aorta with semi-aortic arch replacement.Of the 59 DeBakey type Ⅲ patients,36 underwent descending aortic aneurysm resection with artificial vessel replacement via left posterolateral thoracic incision by left heart bypass or aorta to artery bypass(using Cott tubes),while the other 23 received endovascular stent-graft exclusion in descending aorta via the femoral artery.Results: All the patients were successfully treated except 5 that died during the perioperative period.The survivors were followed up for 3-118 months,among whom 2 died long-term death after the operation and the others were living healthy.Conclusion: Surgical treatment improves the clinical outcome of thoracic aortic dissecting aneurysm.Bilateral perfusion via the carotid artery in aortic arch replacement has a definite cerebral protective effect.Surgical procedures can be simplified by using the modified elephant trunk technique.Endovascular stent-graft exclusion is safe and effective in the treatment of DeBakey type Ⅲ aortic dissection.

Disseminated Intravascular Coagulation Associated with Aortic Dissecting Aneurysm

Disseminated intravascular coagulation (DIC) is an acquired coagulation disorder that occurs when the normal hemostatic balance is disturbed, primarily by excessive thrombin formation. Moreover, while DIC is a rare complication of aortic dissecting aneurysm, it is also a well-recognized one. We reported a case of DIC associated with aortic dissecting aneurysm in a 55-year-old woman who was transferred from another hospital because of chest pain radiating to her back and thrombocytopenia. Laboratory findings showed DIC with severe thrombocytopenia, and she was diagnosed as having an acute aortic dissection and DIC. After medical treatment on the aortic dissecting aneurysm, her DIC profile recovered.

An aortic dissection in pregnant woman - a case report - / 영남의대학술지

We have experienced a case of aortic dissecting aneurysm in pregnant woman. She felt initially severe chest pain which was radiated to the neck on the 3days before delivery. Thereafter dyspnea and generalized edema were developed for 1 month after delivery. She was diagnosed as aortic dissectLn, Debakey type-II. During cardiopulmonary bypass, the selective cerebral perfusion was done through the right and left commom carotid arteries. Aortic replacement with Hemashield vascular graft and reimplantation of innominate artery, resuspension of aortic valve, repair of intimal tear were performed. The postoperative course was uneventful.