Over the past 4 years, in cases of acute type I or II dissections, we preferred an open distal anastomosis without cross-clamping of the aorta. Conclusions: We used composite graft replacement in 18 patients without any complication in this segment. Variables evaluated were patient age, sex, NYHA class, study group (Marfan patients versus non Marfan patients), time of operation, type of dissection (DeBakey I,II or III, acute or chronic dissection or chronic aneurysm), different aortic locations, emergency operation, cardiac tamponade, bypass time, different methods of myocardial protection, operative techniques (composite graft versus non-composite graft surgery), arch replacement, aortic valve regurgitation, additional coronary artery disease, reoperations and recidives. A total of 78.8% of MfS patients and 54.4% of group B patients presented with moderate or severe concomitant aortic valve regurgitation. Uchida K, Io A, Akita S, Munakata H, Hibino M, Fujii K, Kato W, Sakai Y, Tajima K, Mizobata Y. The mean age of the patients was 73 years. Since aortic dissection occurs in aortic dilatation, it seems reasonable to replace a dilated aorta as early as possible. A false aneurysm (pseudoaneurysm) is caused by blood leaking through the arterial wall but contained by the adventitia o… What is the Survival Rate Of An Aortic Dissection? After 1994, postoperative prophylactic β-adrenergic blockade was used in all MfS patients, in order to reduce the progression of aortic dilatation and to prevent the development of aortic complications . Another MfS patient, whose aortic arch was replaced 3 years after replacement of the ascending aorta, developed progressive aneurysmal dilatation of the descending aorta from 4 to 7.2 cm in diameter within 6 months, leading to a second reoperation. Aneurysm ruptures result in deadly hemorrhage in 80% of cases and in case the patient survives to reach the ER unit and does not die of sudden cardiovascular collapse, urgent surgery has a … According to statistics, at least 20% of the patients die before they reach the hospital. Data was analyzed by both univariate and multivariate analysis. [Article in Lithuanian] Cypiene R(1), Grebelis A, Semeniene P, Zakarkaite D, Nogiene G, Uzdavinys G, Sirvydis V. Epub 2018 May 9. Preoperative risk score for the prediction of mortality after repair of ruptured abdominal aortic aneurysms. If you or someone you love needs to have surgery for an aortic aneurysm, you’ll want to … Conroy DM, Altaf N, Goode SD, Braithwaite BD, MacSweeney ST, Richards T. Perspect Vasc Surg Endovasc Ther. NLM The 10-year survival rate after the repair of an aortic aneurysm is 59 percent, as the National Center for Biotechnology Information reports. Oxford University Press is a department of the University of Oxford. This study aims to compare long-term results of surgically treated aortic aneurysms and dissections in patients with and without MfS in respect to early and late prognosis. Marsele et al. Applying this technique, the aortic arch can be examined for additional intimal tears in order to include that part of the vessel in the resection. 2016 Nov;64(5):1497-1502. doi: 10.1016/j.jvs.2016.05.085. To improve long-term prognosis in these patients, efforts must be made to decrease the incidence of aortic dissection and redissection, leading to further operations. Using this technique, the incidence of early and late pseudoaneurysms was markedly reduced . In contrast, there was no difference between the incidence of aneurysms versus dissections in group B (Table 1). If the ascending aorta has to be replaced, we recommend the composite graft technique and a more aggressive approach to reduce the prevalence of distal reoperations. Abdominal aortic aneurysms are fairly common and can be life-threatening if not treated immediately. Numata S, Yamazaki S, Tsutsumi Y, Ohashi H. Interact Cardiovasc Thorac Surg. An endovascular repair of an abdominal aortic aneurysm isn’t as troubling to consider when compared to the more invasive, … In conclusion, the surgical treatment of aneurysms of the thoracic aorta in MfS-patients is associated with a considerably higher risk of redissection and recurrent aneurysm compared to other etiologies of aortic disease. A total of 22 MfS patients had to undergo surgery due to acute (57.6%) or chronic (9.1%) aortic dissections. The causes of late death are shown in Table 4 . These findings suggest that the factors (loss of consciousness, creatinine level, hemoglobin level) that are predictive of death may be a reflection of shock in this patient population. Methods: Nine MfS patients (27.3%) underwent more than one reoperation. 1 shows the Kaplan–Meier long-term survival. Women are much less frequently affected. The influence of aortic dissection on overall survival showed a significantly lower survival for acute or chronic dissection compared to aneurysms and was lowest in acute dissection (P≪0.001, Fig. A total of 29 patients in group B and 3 patients in the MfS group underwent concomitant operative procedures. Reoperations (P≪0.001) and recidives (P≪0.001) were significant risk factors for late death. 4 ). Epub 2011 Aug 1. Altogether, 11 patients (33.3%) with MfS and 62 not MfS-related patients (20.8%) were urgent, while 19 MfS patients (57.6%) and 135 group B patients (45.3%) had to undergo emergency surgical intervention. Use of the Hardman index in predicting mortality in endovascular repair of ruptured abdominal aortic aneurysms. Operative therapy of thoracic aortic aneurysms and dissections are still representing a major surgical challenge associated with a high perioperative mortality. USA.gov. The survival rates after 5, 10 and 15 years in group A were 82±7, 60±11 and 30±22%, respectively, in group B 75±3, 69±3 and 64±4%. Ascending aortic aneurysm >4.5 cm in patients undergoing aortic valve surgery. Abdominal aortic aneurysms are often found during an examination for another reason or during routine medical tests, such as an ultrasound of the heart or abdomen.To diagnose an abdominal aortic aneurysm, doctors will review your medical and family history and do a physical exam. MfS patients suffering from acute aortic dissection more likely required reoperation compared to patients with aortic aneurysm. Acute dissections occurred in 57.6 (A) versus 37.9% (B). The preoperative New York Heart Association (NYHA) functional class was 3.4±0.8 in A and 3.1±0.9 in B. If the ascending aorta needs to be replaced, we recommend the composite graft technique and a more aggressive approach to reduce the frequency of distal reoperations. 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