Surgical management of coronary malperfusion due to acute type A aortic dissection

VernacularTitle:冠状动脉受累的急性A型主动脉夹层的外科治疗
Author: Wei QIN ; Xin CHEN ; Fuhua HUANG
Publication Type:Journal Article
Keywords: Aortic dissection; Coronary malperfusion; Coronary artery bypass grafting
From: Chinese Journal of Thoracic and Cardiovascular Surgery 2015;31(12):729-731
CountryChina
Language:Chinese
Abstract: Objective To investigate the surgical treatment of coronary malperfusion due to acute type A aortic dissection.Methods The clinical data of 305 consecutive patients with type A aortic dissection, who were hospitalized and underwent operation between 2004 and 2015, were analyzed retrospectively.Among that, there were 37 cases with coronary malperfusion due to aortic dissection.Results The right coronary artery was involved in 33 cases, the left in 2 cases, and both coronary arteries in 2 cases.There were 22 coronary bypass grafting using saphenous vein in 21 patients, including 20 patients with the right coronary bypass grafting and 1 patient with the left.Six patients died postoperatively, with the mortality of 16.22％.Conclusion Acute type A aortic dissection with coronary involvement is associated with high mortality rate, which is necessary to restore the coronary revascularization as soon as we can.The methods to reconstruct the involved coronary is depend on the patients' condition and experience of surgeon.