Ann Cardiovasc Surg | Volume 1, Issue 1 | Research Article | Open Access
Elisa Mikus1*, Mauro Del Giglio2, Alberto Tripodi1, Simone Calvi1, Marco Panzavolta1, Gianluca Campo3 and Alberto Albertini1
1Department of Cardiovascular Surgery, Maria Cecilia Hospital, Italy
2Department of Cardiovascular Surgery, Clinical Institute San Rocco, Italy
3Department of Cardiology, Azienda Ospedaliera Universitaria di Ferrara, Italy
*Correspondance to: Elisa Mikus
Fulltext PDFIntroduction: Standard surgical therapy of type A dissection consists of replacing the ascending aorta and, if necessary, the aortic root and or aortic arch with resection of the entry tear. The debate regarding the best surgical approach is still open. The purpose of this study is to evaluate clinical outcome after surgery for acute type A dissection limited to ascending aorta replacement with distal clamping in normothermic cardiopulmonary bypass.Materials and
Methods: Between January 2010 and March 2016, 154 consecutive patients underwent surgical operation for type A aortic dissection at our Institution. This study is focused on 103 of them operated using standard aortic normothermic cross clamp technique, as the aortic arch was not involved. There were 69 (67%) male with a mean age of 63.3 ± 12.9 years (range: 31-84 years). Major morbidity, operative mortality and two-year actuarial survival were analysed.Results: Emergency operations were performed in all patients. An aortic repair involving the aortic root was necessary in 23 patients (nº7 treated with valve sparing and 16 with a valve conduit). Overall median cardiopulmonary bypass time was 114 (IQR 88-146) minutes and aortic cross clamp time was 87 (IQR 63-111) minutes. Median intensive care and hospital stay were 4 and 9 days respectively. In-hospital mortality was 7%. The 2-year overall survival after discharge was 87%.Conclusions: This study shows that type A aortic dissection in selected patients can be treated with aortic cross clamp avoiding hypothermic arrest or moderate hypothermia with cerebral perfusion. Results are encouraging and the follow-up suggests that it could be considered a good alternative.
Type A dissection; Cross clamp technique; Open distal anastomosis; Axillary arterial cannulation
Mikus E, Del Giglio M, Tripodi A, Calvi S, Panzavolta M, Campo G, et al. Single-Centre Experience in the Management of Type a Acute Dissection with Cross Clamp Technique. Ann Cardiovasc Surg. 2018; 1(1): 1007.