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2012 | 84 | 1 | 23-30
Article title

Own Clinical Observations of Treatment Outcome in Acute Type B Aortic Dissection

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EN
Abstracts
EN
The aim of the study was to analyse early results of treatment of acute type B aortic dissection.Material and methods. 59 patients, treated between 1998 and 2011, were divided into four groups. Group I comprised ten patients in whom hybrid procedures were performed: extra-anatomical by-pass graft from the brachio-cephalic trunk to the left carotid artery in six patients, transposition of the left carotid artery to the right one in two patients, and reversed Y prosthesis from the brachio-cephalic trunk to both carotids in the remaining 2 patients, to facilitate stent-grafting. Group II comprised 13 patientsin whom endovascular procedures were performed (stent-grafting). Group III comprised 21 patients in whom conventional surgery was done. Group IV comprised 15 patients who were treated conservatively.Results. In group I, a very good clinical outcome, without complications, was achieved in six patients (60% of cases). The total mortality rate was 40%. One patient died on the operation table, following stent-grafting, due to the rupture of the aortic arch. Two patients died as a result of brain damage (cerebral aneurysm rupture in one, and ischemic stroke in the other). In one patient, an aorto-oesophageal fistula developed. In group II, one patient died during endovascular procedure. Another patient suffered from type 1 endoleak, requiring repeated endovascular surgery. In group III, 15 patients (72%) died. Moreover, four patients required acorrective cardiac surgery (Bentall procedure)which in three patients resulted in death. Thus, the total mortality rate in this group was as high as 85%. In group IV, the mortality rate was 13%.Conclusions. We noticed a clear superiority of endovascular procedures over conventional surgeries-for acute type B aortic dissection. Hybrid procedures for acute, complicated type B aortic dissection evidently reduce mortality and postoperative morbidity. Uncomplicated acute type B aortic dissections should be treated conservatively at intensivecare units.
Publisher

Year
Volume
84
Issue
1
Pages
23-30
Physical description
Dates
published
1 - 1 - 2012
online
3 - 4 - 2012
Contributors
  • Department of Surgery, 4 Military Clinical Hospital in Wrocław
author
  • Department of Vascular, General and Transplantological Surgery, Medical University in Wrocław
  • Department of General Radiology, Interventional Radiology and Neuroradiology, Medical University in Wrocław
  • Department of Surgery, 4 Military Clinical Hospital in Wrocław
  • Department of Surgery, 4 Military Clinical Hospital in Wrocław
  • Department of Surgery, 4 Military Clinical Hospital in Wrocław
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Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-012-0004-5
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