[Surgical Outcomes of Aortic Root Repair in Type A Acute Aortic Dissection].

We carried out a retrospective evaluation of the early and long-term outcomes of aortic root reconstruction for type A acute aortic dissection. Between January 2001 and March 2015, a total of 21 patients underwent aortic root reconstruction. Bentall operation was performed in 9 patients( B group) and Patch plasty of sinus of Valsalva patients was performed in 12 patients (V group). There were 3 in-hospital deaths due in the B group and 1 death due in the V group. Overall survival in the V group was 72.9% and was not significantly different from survival in the B group(66.7%). In conclusion, our study demonstrated good early and long-term outcomes for patch plasty of sinus of Valsalva for type A acute aortic dissection. There was no postoperative patch-related complication in the V group. Thus, a patch plasty of sinus of Valsalva for type A acute aortic issection may be acceptable.

[Single-stage procedure for multiple dissected aortic aneurysms with coagulopathy in an elderly patient].

An 86-year-old man was admitted for abdominal pain. Dissected descending thoracic aortic aneurysm and infrarenal abdominal aortic aneurysm were observed under computed tomographic (CT) scan. Hematologic studies revealed low platelet count and an increase in fibrin degradation products (FDP), and disseminated intravascular coagulation( DIC) associated with dissecting aortic aneurysm was highly suspected. Platelet transfusion was performed and gabexate mesilate was administered, however, no improvement of DIC could be obtained. An increase in aortic diameter was observed under CT scan and surgery was performed. The infrarenal aneurysm was replaced with a bifurcated prosthetic graft under open repair. Simultaneously, an endovascular stent-graft was delivered from the left limb of the abdominal graft and implanted into the descending thoracic aorta. The postoperative recovery was uneventful but platelet count did not improve in this case.