Resultados imediatos e tardios do tratamento cirúrgico dos aneurismas e dissecçoes da aorta ascendente / Immediate and late results of the surgical treatment of the aneurysms and dissections of the ascending aorta

RESUMO

PURPOSE: To report our experience and results with the surgical treatment of aortic aneurysms and dissections of the ascending aorta as well as the techniques that have been used. METHODS: Between May 1982-May 1995, 54 patients were operated on and divided in two groups: group A was composed of 25 patients with aneurysms or chronic dissections of the ascending aorta. The Bentall and DeBonno procedure was performed in 18, five were submitted to prosthetic aortic graft associated with aortic valve replacement and two prosthetic aortic graft without aortic valve replacement. Group B had 29 patients with acute dissections of the ascending aorta (type A) who were submitted to 10 prosthetic graft alone, nine Bentall procedures, five prosthetic graft with aortic valve replacement, four aortic repair and one direct suture of the dissection. The survival curve was obtained by the Kaplan-Meier method. RESULTS: Total hospital mortality rate was 13 and the late was 18.5. Group A-immediate mortality rate was 8 (two patients): Low cardiac output and stroke; late mortality rate was five (20): sudden death in three, pulmonary embolism one and infectious endocardite one. Group B-hospital mortality rate was five (17.2) patients: low cardiac output three, multiple organs failure one and stroke with pneumonia one; late mortality rate was five (17.2), distal redissection in three, sudden death in two. The average survival time was 86 +/- 12 for group A and 75 +/- 13 months for group B. CONCLUSION: The surgery of the aneurysm and dissections of the ascending aorta has shown immediate favorable results and a thorough follow-up to get better late results is needed.