Surgical treatment for 37 patients with acute type A aortic dissection involving coronary arteries
10.3760/cma.j.issn.1001-4497.2018.08.005
- VernacularTitle:37例急性A型主动脉夹层累及冠状动脉患者的手术治疗
- Author:
Ming GONG
1
;
Xinliang GUAN
;
Xiaolong WANG
;
Yuyong LIU
;
Haiyang LI
;
Wenjian JIANG
;
Jiachen LI
;
Yang LIU
;
Hongjia ZHANG
Author Information
1. 100029,北京心肺血管疾病研究所 首都医科大学附属北京安贞医院心脏外科
- Keywords:
Acute aortic dissection;
Acute coronary involvement;
Coronary artery bypass graft
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(8):465-468
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the treatment experience and strategies of patients with acute type A aortic dissection involving coronary arteries in order to improve the efficacy of such patients.Methods Between March 2013 and April 2016,we recruited 37 patients with coronary involvement caused by acute type A aortic dissection,26 men,11 women;mean age (49.7 ± 10.4) years.All procedures were done on an emergency basis within 24 hours after the patient's arrival.Results Acute type A aortic dissection with coronary involvement is a more complex operation associated with high in-hospital mortality(18.9％,7/37) and low short-term survival(64.9％,13/37).There were 9 patients underwent coronary artery bypass graft after completion of the root procedure because of ventricular wall motion abnormality(7 patients) and new ST-segment elevation (2 patients) during weaning from cardiopulmonary bypass.Four of them were survival during follow-up due to the success from rescue coronary artery bypass graft.Conclusion Acute type A aortic dissection with coronary involvement is associated with high in-hospital mortality and low short-term survival.If patients suffered abnormal ventricular wall motion or new ST-segment elevation during weaning from cardiopulmonary bypass,rescue coronary artery bypass graft is essential to salvage these critically ill patients.
