Result of type a dissecting aortic aneurysms surgical treatment during the 3 years (2010 - 2012)

Methods 148 consecutive patients with type A TAAD were operated on during 2010 2012 (122 (82,4%) males). Their age ranged 20 – 77 years, mean 49,3 ± 9,6. Acute (subacute) dissection was in 128 (86,5%), chronic – in 20 (13,5%). The causes of aneurysms forming were: arterial hypertension, atherosclerosis – in 91 (61,5%); BAV – 18 (12,2%); MS – 16 (9,8%); cystomedianecrosis – 16 (10,8%); blunt aortic injury – in 2 (1,4%) cases, unknown – 5 (3,4%); 96 (64,8%) patients had type I, others 52 (35,2%) – type II according De Bakey classification. The preoperative status included: acute aortic valve insufficiency 64 (43,2%); haemopericardium (heart tamponade) 26 (17,6%); acute renal insufficiency 12 (8,1%); left ventricle failure with pulmonary edema 5 (3,4%); multiorgan failure 4 (2,7%) patients. All operations were performed with bypass, mild hypothermia (26-30oC), 42 (28,4%) patients with arch injury deep hypothermia (18-20oC) and retrograde cerebral perfusion. We used: supracoronary grafting with valve resuspensionin 98 (66,2%) pts, Bentall-de Bono operation in 48 (32,4%); David operation in 2 (1,4%).