Surgical treatment of acute type A dissection with mitral regurgitation
10.3760/cma.j.cn112434-20190312-00067
- VernacularTitle:急性Stanford A型主动脉夹层合并二尖瓣反流的外科治疗
- Author:
Chengnai LI
1
;
Junming ZHU
;
Ruidong QI
;
Yi YANG
;
Hai YU
;
Xiaoyan XING
;
Suwei CHEN
;
Yongmin LIU
;
Lizhong SUN
Author Information
1. 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所 心脏外科中心 北京市主动脉疾病诊疗中心 100029
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2020;36(8):478-480
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Acute type A dissection with mitral regurgitation was very rare. To sum up our experience of surgical treatment of acute type A dissection with mitral regurgitation.Methods:From October 2010 to January 2017, 17 patients with acute type A dissection with mitral regurgitation underwent surgical treatment. There were 12 males, 5 females; mean age, (38±11) years(range, 18-59 years). Hypertension was noted in 9 patients, Marfan syndrome in 2 patients, renal dysfuction in 3 patients, cardiac dysfunction in 3 patients, lower limb ischemia was observed in 2 patients and dilated cardiomyopathy in one patient. Preoperative abdominal aortic replacement was observed in one case.Results:Concomitant procedures included Bentall procedure in 16 patients, aortic arch operation in 15 patients, tricuspid valve plasty in 3 patients, coronary artery bypass grafting in 2 patients and asceding aorta - femoral artery bypass in one patient. 11 patients required mechanical ventilation for <24 hours, 3 cases for <48 hours and 3 subjects for > 48 hours. Continuous renal replacement therapy was required in 3 patients, re-operation in one patient and partial pericardial excision in one patient. One patient was out of follow-up. The remaining had a normal life during follow-up.Conclusion:Repair of acute type A dissection with mitral regurgitation carried with a relatively high mortality and morbidity. Under better protection of heart and cerebrum, it obtained accepted surgical results in patients with this lesion
