Total and Subtotal Aortic Replacement for Extensive Aortic Dissection in Patients with or without Marfan's Syndrome

• Published in: General thoracic and cardiovascular surgery Vol. 50; no. 8; pp. 315 - 320
• Main Authors: Yamashita, Katsushi, Kazui, Teruhisa, Terada, Hitoshi, Washiyama, Naoki, Suzuki, Takayasu, Ohkura, Kazuhiro, Doi, Hirosato, Okawa, Yohei, Suzuki, Kazuchika, Ono, Takemi
• Format: Journal Article
• Language: English
• Published: Japan Springer Nature B.V 01.08.2002
• Subjects: Adult; Aorta - surgery; Aortic Aneurysm - surgery; Aortic dissection; Aortic Dissection - surgery; Blood Vessel Prosthesis; elephant trunk technique; Female; Humans; Male; Marfan Syndrome - complications; Marfan's syndrome; Middle Aged; subtotal aortic replacement; thoracoabdominal replacement; total aortic replacement
• ISSN: 1344-4964; 1863-6705; 1863-2092; 1863-6713
• DOI: 10.1007/BF03032623

Extensive aortic dissection with multiple entries often found in Marfan's syndrome patients ultimately requires replacement of the whole aorta. We present a surgical strategy and results for total and subtotal aortic replacement. Subjects were 18 patients, including 14 Marfan's patients undergoing total (n = 13) or subtotal (excluding aortic arch) aortic replacement (n = 5), for DeBakey type I aortic dissection (n = 13) and DeBakey type IIIb aortic dissection with annuloaortic ectasia (n = 5) between February 1991 and April 2001. Mean age was 39.9 +/- 0.8 years--34.9 +/- 6.6 years in Marfan's patients vs. 57.7 +/- 4.7 years in non-Marfan patients. All operations were staged, with the mean number required per patient 3.1 +/- 0.8. Early mortality was 0% and late mortality 11% (2 of 18). Paraplegia or paraparesis occurring in 11%. Except for these patients, all current survivors enjoy good quality of life. Total and subtotal aortic replacement for extensive aortic dissection may decrease mortality due to rupture or associated disease.