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Revista Brasileira de Cirurgia Cardiovascular

Print version ISSN 0102-7638

Abstract

CASTRO, Marcelo F et al. Intraoperative acute dissection of the ascending aorta. Rev Bras Cir Cardiovasc [online]. 1996, vol.11, n.1, pp. 7-11. ISSN 0102-7638.  http://dx.doi.org/10.1590/S0102-76381996000100003.

In order to demonstrate the surgical experience of Biocor Hospital with intraoperative acute dissection of the ascending aorta, we reviewed retrospectively 7 251 patients who underwent a cardiac procedure with cardiopulmonary bypass, from January 1988 through January 1995; 11 patients who developed this complication were identified. There were 6 men (54.5%) and 5 women (45.5%), aged 54 to 80 years (mean 66.73±7.54 years). The primary cardiac procedure were: myocardial revascularization in 9 patients: myocardial revascularization plus left ventricular aneurismectomy in 1 (9.1%) and aortic valve replacement in 1 (9.1%) patient. All patients had a previous history of systemic arterial hypertension. In 9 (81.8%) an abnormal ascending aorta was observed during the operation. The surgical repair included: replacement of the ascending aorta with interposition of bovine pericardial graft in 7 (63.6%); replacement of ascending aorta with interposition of valved bovine pericardial graft in 1 (9.1%); aortic reconstruction with bovine pericardial patch in 3 (27.3%) patients. In 90.9% of the cases, deep hypothermia and circulatory arrest was employed. Hospital mortality was 45.5% (5 patients): 2 patients could not be weaned from cardiopulmonary bypass; massive hemorrhage in 1 and postoperative low cardiac output in 2 patients. Follow-up information was available on 5 of 6 hospital survivors, and all are free of cardiac symptoms. We concluded that intraoperative acute aortic dissection is a strongly fatal complication of cardiac procedures. The use of preventive measures when an abnormal ascending aorta is noted must be taken to reduce it's incidence.

Keywords : Ascending aorta [acute dissection]; Ascending aorta [surgery].

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