Surgical treatment of type A aortic dissection in elderly patients
10.3760/cma.j.cn112434-20191029-00380
- VernacularTitle:高龄Stanford A型主动脉夹层外科治疗临床分析
- Author:
Honglei ZHAO
1
;
Tao BAI
;
Jinrong XUE
;
Yongming LIU
;
Lizhong SUN
Author Information
1. 首都医科大学附属北京安贞医院心脏外科 北京市心肺血管疾病研究所 北京大血管疾病诊疗中心 100029
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2020;36(5):268-272
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical efficacy of surgical treatment of elderly patients with type A aortic dissection(TAAD).Methods:A retrospective study including 139 elderly patients(age≥60 years) with TAAD between August 2016 to August 2018 in Beijing Anzhen Hospital was performed. There were 90 male patients(64.7%) and 49 female patients(35.3%), aged 60-80(65.1±3.8)years. All patients completed the necessary preoperative examination, 123 patients underwent emergency surgery and the other 16 patients underwent elective surgery. Deep hypothermia circulatory arrest(DHCA) and selective cerebral perfusion(SCP) were used in arch surgery. The root surgery was divided into Bentall, Wheat, David and ascending aorta replacement and the arch surgery was divided into partial aortic arch replacement, classic Sun's procedure, and modified Sun's procedure. Bypass surgery was done when pressure difference(≥40 mmHg, 5.33 kPa) between upper and lower extremities existed. Other combined heart diseases were treated at the same time.Results:Operative mortality rate was 5.0%(7 cases), 5 case(3.6%)with multiple organ dystuaction syndrome, 1 case(0.7%)with respiratory failure and 1 case(0.7%) with heart failure. The postoperative complications were hypoxemia(12.2%), neurological complications(10.8%), acute kidney injury(13.7%).Conclusion:Surgical treatment is the first choice for aged patients with TAAD and individualized treatment is safe and effective.
