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Surgical repair of type a aortic dissection
Asia Pacific
J Thorac
Cardiovasc
Cardiothoracic
Surg 1995;4(1)
abstracts
chest pain was the presenting symptom in 76% of patients, and one-third were misinterpreted as myocardial ischaemia. Signs of aortic incompetence were present in all but 4 patients. CT scanning was the commonest modality of definitive diagnosis. However, transoesphageal echocardiography was used as confirmation wherever possible, and is now considered as the “gold standard”.
Cardiopulmonary Bypass For Non-cardiac Surgery C Manganas , H.D . Wolfenden Department of Cardiac Surgery, The Prince Henry Hospital, Sydney, New South Wales, Australia A retrospective study of 13 patients (from 19801994) having non-cardiac surgery on cardiopulmonary bypass was performed. The patients were in one of the following categories: intracranial surgery, renal tumour invading the inferior vena cava and/or right atrium, pulmonary embolectomy, cardiac catheter lab high-risk patients, and refractory ventricular arrhythmias following acute intoxication.
There were 13 Bentall type procedures, 4 ascending aortic coronary replacements with aortic valve resuspension, and 15 supracoronary ascending aortic replacements. Mean bypass time was 165 minutes, and mean hospital stay was 2 days. The overall mortality at 30 days after surgery was 18.7% which compares favourably with results in the literature. There were 6 early deaths (most commonly due to low cardiac output syndromes) and 7 late deaths (most commonly due to either sepsis or persistence of the false lumen). Mean follow-up among the survivors was 3.6 years, with only 1 survivor having functional long-term disabilities.
We reviewed potential patients for cardiopulmonary bypass, elective or acute in the absence of primary cardiac surgery. Methods of instituting cardiopulmonary bypass, complications arising from patients having been on cardiopulmonary bypass, and patient survival following cardiopulmonary bypass and their primary procedure were reviewed. There are also other uncommon situations where cardiopulmonary bypass for non-cardiac surgery might be considered.
Gelatin-Resorcine-Form01 Glue In Acute Aortic Dissections
Ventricular Assist Devices In Paediatric Cardiac Surgery R.J. Costa,. T.C. Cartmill, G. Nunn, R. Chard
I. Nicholson, R. Chard, G. Nunn Department of Cardiothoracic Surgery, Westmead Hospital, Westmead, New South Wales, Australia An acute dissection involving the ascending aorta is a surgical emergency. Approximately 50% of patients die within 48 hours of the onset of symptoms. Surgical therapy is aimed at preventing death by intrapericardial rupture or acute aortic regurgitation. The use of GRF glue since the late 1970s has been reported to improve the immediate and long-term results of repair with hospital mortality of 10%. The biological glue is simple and safe to use. The proximal aortic stump can be anatomically reconstructed, and generally the aortic valve can be preserved and coronary reimplantation avoided. The perioperative and postoperative bleeding rates are reported to be lower with use of the glue, and the risk of maintenance or recurrence of the dissection process is reduced.
Department of Cardiac Surgery, Royal Alexandra Hospital for Children, Sydney, New South Wales, Australia Extracorporeal life support with ventricular assist devices is well documented and accepted in adult cardiac surgery. In children experience with assist devices is limited. Ventricular assist devices were used in 12 children ranging in weight from 2.9 to 13.8 kg and aged from 4 days to 2.5 years. The devices were used from 1.5 hours to 9 days. 11 patients required a VAD to wean from cardiopulmonary bypass or perioperatively following repair of congenital cardiac defects. One child was supported after a kick to the chest by a horse resulted in myocardial infarction and cardiogenic shock. All patients initially responded to ventricular assistance. Six patients were successfully decannulated. Complications included haemorrhage, tamponade, mitral valve damage, sepsis, renal failure and cerebrovascular accident. Ventricular assistance is useful when cardiac dysfunction is temporary and the surgery has been corrective.
We have used GRF biological glue in a small number of patients with ascending aortic dissection.
Clinical And Haemodynamic Performance Of The 19 mm Carpentier-Edwards Pericardial Bioprosthesis A.W. Pick, A. White, A.C. Wilson Open Heart Surgery Clinic, St Vincent’s Hospital, Melbourne, Victoria, Australia To determine the intermediate and long-term haemodynamic performance of the 19mm CarpentierEdwards pericardial bioprosthesis, we have retrospectively reviewed the clinical results in 55 patients, together with an echocardiographic evaluation
Surgical Repair Of Type A Aortic Dissection E. La Hei, P. Brady, D. Ross, D. Marshman Department of Cardiothoracic Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia Surgical treatment was undertaken for type A aortic dissection in 32 patients between January 1988 and August 1994 at Royal North Shore Hospital. Retrosternal
35
J Thorac
Cardiovasc
Cardiothoracic
Surg 1995;4(1)
abstracts
chest pain was the presenting symptom in 76% of patients, and one-third were misinterpreted as myocardial ischaemia. Signs of aortic incompetence were present in all but 4 patients. CT scanning was the commonest modality of definitive diagnosis. However, transoesphageal echocardiography was used as confirmation wherever possible, and is now considered as the “gold standard”.
Cardiopulmonary Bypass For Non-cardiac Surgery C Manganas , H.D . Wolfenden Department of Cardiac Surgery, The Prince Henry Hospital, Sydney, New South Wales, Australia A retrospective study of 13 patients (from 19801994) having non-cardiac surgery on cardiopulmonary bypass was performed. The patients were in one of the following categories: intracranial surgery, renal tumour invading the inferior vena cava and/or right atrium, pulmonary embolectomy, cardiac catheter lab high-risk patients, and refractory ventricular arrhythmias following acute intoxication.
There were 13 Bentall type procedures, 4 ascending aortic coronary replacements with aortic valve resuspension, and 15 supracoronary ascending aortic replacements. Mean bypass time was 165 minutes, and mean hospital stay was 2 days. The overall mortality at 30 days after surgery was 18.7% which compares favourably with results in the literature. There were 6 early deaths (most commonly due to low cardiac output syndromes) and 7 late deaths (most commonly due to either sepsis or persistence of the false lumen). Mean follow-up among the survivors was 3.6 years, with only 1 survivor having functional long-term disabilities.
We reviewed potential patients for cardiopulmonary bypass, elective or acute in the absence of primary cardiac surgery. Methods of instituting cardiopulmonary bypass, complications arising from patients having been on cardiopulmonary bypass, and patient survival following cardiopulmonary bypass and their primary procedure were reviewed. There are also other uncommon situations where cardiopulmonary bypass for non-cardiac surgery might be considered.
Gelatin-Resorcine-Form01 Glue In Acute Aortic Dissections
Ventricular Assist Devices In Paediatric Cardiac Surgery R.J. Costa,. T.C. Cartmill, G. Nunn, R. Chard
I. Nicholson, R. Chard, G. Nunn Department of Cardiothoracic Surgery, Westmead Hospital, Westmead, New South Wales, Australia An acute dissection involving the ascending aorta is a surgical emergency. Approximately 50% of patients die within 48 hours of the onset of symptoms. Surgical therapy is aimed at preventing death by intrapericardial rupture or acute aortic regurgitation. The use of GRF glue since the late 1970s has been reported to improve the immediate and long-term results of repair with hospital mortality of 10%. The biological glue is simple and safe to use. The proximal aortic stump can be anatomically reconstructed, and generally the aortic valve can be preserved and coronary reimplantation avoided. The perioperative and postoperative bleeding rates are reported to be lower with use of the glue, and the risk of maintenance or recurrence of the dissection process is reduced.
Department of Cardiac Surgery, Royal Alexandra Hospital for Children, Sydney, New South Wales, Australia Extracorporeal life support with ventricular assist devices is well documented and accepted in adult cardiac surgery. In children experience with assist devices is limited. Ventricular assist devices were used in 12 children ranging in weight from 2.9 to 13.8 kg and aged from 4 days to 2.5 years. The devices were used from 1.5 hours to 9 days. 11 patients required a VAD to wean from cardiopulmonary bypass or perioperatively following repair of congenital cardiac defects. One child was supported after a kick to the chest by a horse resulted in myocardial infarction and cardiogenic shock. All patients initially responded to ventricular assistance. Six patients were successfully decannulated. Complications included haemorrhage, tamponade, mitral valve damage, sepsis, renal failure and cerebrovascular accident. Ventricular assistance is useful when cardiac dysfunction is temporary and the surgery has been corrective.
We have used GRF biological glue in a small number of patients with ascending aortic dissection.
Clinical And Haemodynamic Performance Of The 19 mm Carpentier-Edwards Pericardial Bioprosthesis A.W. Pick, A. White, A.C. Wilson Open Heart Surgery Clinic, St Vincent’s Hospital, Melbourne, Victoria, Australia To determine the intermediate and long-term haemodynamic performance of the 19mm CarpentierEdwards pericardial bioprosthesis, we have retrospectively reviewed the clinical results in 55 patients, together with an echocardiographic evaluation
Surgical Repair Of Type A Aortic Dissection E. La Hei, P. Brady, D. Ross, D. Marshman Department of Cardiothoracic Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia Surgical treatment was undertaken for type A aortic dissection in 32 patients between January 1988 and August 1994 at Royal North Shore Hospital. Retrosternal
35