ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Marc A.A.M. Schepens
Karl M. Dossche
Roberto Di Bartolomeo
Angelo Pierangeli
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Di Eusanio, M.
Right arrow Articles by Morshuis, W. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Di Eusanio, M.
Right arrow Articles by Morshuis, W. J.
Related Collections
Right arrow Great vessels

Ann Thorac Surg 2003;75:514-519
© 2003 The Society of Thoracic Surgeons

Original article: cardiovascular

Surgery for acute type A dissection using antegrade selective cerebral perfusion: experience with 122 patients

Marco Di Eusanio, MDa*, M. Erwin S.H. Tan, MDa, Marc A.A.M. Schepens, MD, PhDa, Karl M. Dossche, MD, PhDa, Roberto Di Bartolomeo, MDb, Angelo Pierangeli, MDb, Wim J. Morshuis, MD, PhDa

a Department of Cardiopulmonary Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
b Department of Cardiac Surgery, Policlinico Sant’Orsola, University of Bologna, Bologna, Italy

Accepted for publication August 21, 2002.

* Address reprint requests to Dr Di Eusanio, Department of Cardiopulmonary Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands
e-mail: m_dieus{at}hotmail.com

BACKGROUND: Antegrade selective cerebral perfusion (ASCP) has proved to be a reliable method of brain protection during surgery of the thoracic aorta, but its use during aortic dissection surgery still remains controversial. In this study, we present our results after the operative repair of acute type A aortic dissections using ASCP and moderate hypothermic circulatory arrest.

METHODS: Between October 1995 and August 2001, 122 patients (76 men, 46 women) underwent repair of acute type A aortic dissection with the aid of ASCP and open distal anastomosis. The average age of the patients was 61 ± 12 (mean ± standard deviation). Preoperative complications included cardiac tamponade (n = 34; 27.0%), aortic regurgitation (n = 27; 22.1%), and new neurological deficits (n = 11; 9%).

RESULTS: Stepwise logistic regression revealed preoperative cardiac tamponade (p = 0.018) and new neurological deficits (p = 0.017) to be independent determinants for hospital mortality (19.7%). Permanent neurological complications occurred in 7% of the patients. Independent risk factors for temporary neurological dysfunction (11.2%) included cardiac tamponade (p = 0.019) and preoperative neurological deficits (p = 0.000).

CONCLUSIONS: In our experience, the surgical treatment of acute type A aortic dissection with the aid of ASCP was associated with acceptable hospital mortality and neurologic morbidity rates.




This article has been cited by other articles:


Home page
 Eur J Cardiothorac SurgHome page
M. Di Eusanio, P. Berretta, L. Bissoni, F. D. Petridis, L. Di Marco, and R. Di Bartolomeo
Re-operations on the proximal thoracic aorta: results and predictors of short- and long-term mortality in a series of 174 patients
Eur J Cardiothorac Surg, November 1, 2011; 40(5): 1072 - 1076.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. G. Leshnower, R. J. Myung, P. D. Kilgo, T. A. Vassiliades, J. D. Vega, V. H. Thourani, J. D. Puskas, R. A. Guyton, and E. P. Chen
Moderate Hypothermia and Unilateral Selective Antegrade Cerebral Perfusion: A Contemporary Cerebral Protection Strategy for Aortic Arch Surgery
Ann. Thorac. Surg., August 1, 2010; 90(2): 547 - 554.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
WRITING COMMITTEE MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al.
Special Article: 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine
Anesth. Analg., August 1, 2010; 111(2): 279 - 315.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society of Interventional Radiology, Society of Thoracic Surgeons, Society for Vascular Medicine, et al.
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease
J. Am. Coll. Cardiol., April 6, 2010; 55(14): e27 - e129.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society of Interventional Radiology, Society of Thoracic Surgeons, Society for Vascular Medicine, et al.
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary
J. Am. Coll. Cardiol., April 6, 2010; 55(14): 1509 - 1544.
[Full Text] [PDF]

Home page
 CirculationHome page
WRITING GROUP MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al.
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine
Circulation, April 6, 2010; 121(13): e266 - e369.
[Full Text] [PDF]

Home page
 CirculationHome page
WRITING COMMITTEE MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al.
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine
Circulation, April 6, 2010; 121(13): 1544 - 1579.
[Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
D. L. Reich
Central Nervous System Protection in Cardiac Surgery
Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2010; 14(1): 32 - 37.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. Turkoz, O. Gulcan, L. Oguzkurt, E. Caliskan, and A. Turkoz
Successful Repair of Iatrogenic Acute Aortic Dissection With Cerebral Malperfusion
Ann. Thorac. Surg., January 1, 2006; 81(1): 345 - 347.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. E. S.H. Tan, W. J. Morshuis, K. M.E. Dossche, J. C. Kelder, F. G.J. Waanders, and M. A.A.M. Schepens
Long-Term Results After 27 Years of Surgical Treatment of Acute Type A Aortic Dissection
Ann. Thorac. Surg., August 1, 2005; 80(2): 523 - 529.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
Y. Moizumi, N. Motoyoshi, K. Sakuma, and S. Yoshida
Axillary Artery Cannulation Improves Operative Results for Acute Type A Aortic Dissection
Ann. Thorac. Surg., July 1, 2005; 80(1): 77 - 83.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Di Eusanio, M. A. A. M. Schepens, W. J. Morshuis, K. M. Dossche, T. Kazui, K. Ohkura, N. Washiyama, R. Di Bartolomeo, D. Pacini, and A. Pierangeli
Separate grafts or en bloc anastomosis for arch vessels reimplantation to the aortic arch
Ann. Thorac. Surg., June 1, 2004; 77(6): 2021 - 2028.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. E. S. H. Tan, K. M. E. Dossche, W. J. Morshuis, J. C. Kelder, F. G. J. Waanders, and M. A.A.M. Schepens
Is extended arch replacement for acute Type A aortic dissection an additional risk factor for mortality?
Ann. Thorac. Surg., October 1, 2003; 76(4): 1209 - 1214.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2003 by The Society of Thoracic Surgeons.