Surgical techniques in type A dissection.

نویسندگان

  • Syed T Hussain
  • Lars G Svensson
چکیده

Acute aortic dissection is a surgical emergency that must be urgently managed, with the primary goal of restoring flow to the dominant true lumen in the downstream aorta. Our preference at the Cleveland Clinic is for an open distal anastomosis technique without aortic clamping, as it permits more accurate approximation of dissected layers and more homeostatically secure anastomosis. During this procedure we employ right axillary end-to-side graft perfusion, followed by deep hypothermic circulatory arrest and antegrade brain perfusion. The distal anastomosis is performed without felt strips or glue. Critical to achieving a successful outcome is meticulous de-airing of the arch, diligent myocardial protection, and a water-tight anastomosis prior to discontinuing cardiopulmonary bypass.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Two Techniques of Tonsillectomy Performed in Identical Twins: A Case Report

Introduction:Cold dissection (CD) and bipolar cautery dissection (BCD) techniques are two common surgical tonsillectomy procedures used in the clinic. Obstruction has become more prevalent as the major surgical indication and is most prominently observed in younger children.Case Report:  In this report, we aimed to explain the abovementioned surgical techniques in detail and compare the results...

متن کامل

The use of surgical glue in acute type A aortic dissection.

Acute type A aortic dissection (AAAD) remains a lethal disease. With advances in operative methods and perioperative management, surgical outcomes continue to improve, but in-hospital mortality still ranges from 10 to 30% in most series. The surgical technique of choice for aortic root repair remains controversial. Surgical glue created a breakthrough in surgery for acute aortic dissection. We ...

متن کامل

Clinical trends in optimal treatment strategy for type A acute aortic dissection.

The mortality rate in emergency surgical intervention for type A acute aortic dissection (AAD) has been variously reported as 15%-30%. These findings are often derived from series spanning 10-20 years. Many factors, such as surgical techniques, use of sealed prosthesis, access to cardiopulmonary bypass, cerebral protection techniques, and postoperative surveillance, have markedly changed during...

متن کامل

Best surgical option for arch extension of type B dissection: the endovascular approach.

Despite advances in surgical techniques and postoperative management, the in-hospital mortality rate for patients undergoing conventional open surgical repair for type B dissections is still significant. In light of this, the less invasive surgical procedure for acute type B aortic dissections, defined as thoracic endovascular aortic repair (TEVAR), was developed. Despite some controversy, the ...

متن کامل

Successful Repair of Type a Aortic Dissection in a Term Pregnancy: A Case Report

Stanford type A acute aortic dissection (AAD) is a very rare complication, with potentially lethal consequences in pregnancy. In fact, pregnancy has been regularly associated with the possibility of aortic. dissection in almost half of young women. Herein, we present the case of a 38-year-old woman in her 37th week of pregnancy. The patient’s medical history was indicative of G4L2Ab1(4 gestaiti...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Annals of cardiothoracic surgery

دوره 5 3  شماره 

صفحات  -

تاریخ انتشار 2016