ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Surgjcal Treatment of Acute Aortic Dissections
Suat BUKET, Anıl APAYDIN, Ahmet HAMULU, Mustafa ÖZBARAN, Alp ALAYUNT, Münevver YÜKSEL, Önol BİLKAY, İsa DURMAZ,
*Fatma AŞKAR, *Melek SAKARYA
Ege Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı
*Ege Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Bornova
November-1991 and March-1995, 14 consecutive patients, 13 with Type-l, l with Type-III acute aortic dissection were operated. There were 13 men and l woman, and mean age was 48.6. Ascending aorta replacement in 10 patients, ascending aorta and hemiarch replacement in 2 patients, composite graft and hemiarch replacement in l patient, dessending aorta replace- ment in l patient was performed. Concomittant procedures were aortic valve resuspension in 8 patients, coronary bypass grafting in 1 patient, reimplantation of previous saphenous vein grafts in 1 patient. Retrograde serebral perfusion with deep hypothermia was used for brain protection. Mean circulatory arrest time was 32.3 minutes. One patient died due to left ventricular failure intraoperatively, another patient died due to sepsis and multiorgan failure in postoperative fifth day (overall mortality is %14). All patients except one with stroke awoke neurologically intact within 4-6 hours. Twelve patients were discharged from the hospital and they were in good condition during follow-up (3-18 months). Brain protection is the most important problem of dissections involving ascending aorta and arch, Retrograde cerebral perfusion as an adjunct to deep hypothermia is useful and morbidity.
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