From January 1991 to January 1995, 11 patients with aortic diseases underwent various surgical repairs. The age at operation ranged from 26 years to 63 years (mean=50l9 years).
The disease entities included 8 aortic dissections (type Ⅰ in 4, type Ⅱ in 2 and type Ⅲ in 2 cases), 2 Marfan's syndrome with annuloaortic ectasia and 1 desecending thoracic aortic aneurysm.
The operative procedures we tried were 3 Bentall's operation, 5 graft replacement of ascending aorta, and 3 graft interposition in descending thoracic aorta.
Overall hospital mortality rate is 36.3% (4/11). And causes of death are pump weaning failure in 2 cases and multiorgan failure in 2 cases. It was that 2 sternal dehiscence & mediastinitis, 1 acute renal failure, 2 hypoxic brain damages and 2
postoperative psychosis were complicated.
Recently, we tried surgical repair of aortic dissection 5 out of 6 cases using total circulatory arrest with deep hypothermia at 14℃. Total circulatory arrest time ranged from 18 to 26 minutes (mean 22.2 minutes), and mean aortic cross-clamping
time
was 48. 2 minutes. One of 5 patient died on the 7th postoperative day due to multiorgan failure. Mortality of patients with TCA was 20% (1/5), and that of remainders was 50% (3/6). Our result for surgical repair using total circulatory arrest
with
deep
hypothermia is satisfactory on the basis of our clinical data.
(Korean J Thorac Cardiovasc Surg 1995;28:906-10)
|