Clinical Outcome of Emergency Surgery for Complicated Acute Type B Aortic Dissection

Murashita, Takashi; Ogino, Hitoshi; Matsuda, Hitoshi; Sasaki, Hiroaki; Tanaka, Hiroshi; Iba, Yutaka; Domae, Keitaro; Fujiwara, Tatsuki

doi:10.1253/circj.cj-11-0982

Cited by 23 publications

(13 citation statements)

References 13 publications

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“…Conversely, mortality of open surgery for complicated acute type B dissection is up to 30%. [17][18][19] The Cleveland Clinic reported on TBAD, with open repair operative mortality of 8%, with 2.4% neurologic complications. Survival at 1, 2, and 3 years was 82%, 78%, and 75%, respectively, and 14% required reintervention.…”

Section: Discussionmentioning

confidence: 99%

Endovascular management of chronic symptomatic aortic dissection with the Streamliner Multilayer Flow Modulator: Twelve-month outcomes from the global registry

Sultan

Kavanagh

Stefanov

et al. 2017

Journal of Vascular Surgery

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The SMFM is an option in management of complex pan-aortic dissection. Results highlight SMFM implantation leads to dissection stabilization with no further aneurysm progression, and no retrograde type A dissection. Thoracic endovascular aneurysm repair by SMFM ensued in freedom from aortic rupture, neurologic stroke, paraplegia and renal failure. Further analysis of the global registry data will inform long-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Endovascular management of chronic symptomatic aortic dissection with the Streamliner Multilayer Flow Modulator: Twelve-month outcomes from the global registry

Sultan

Kavanagh

Stefanov

et al. 2017

Journal of Vascular Surgery

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“…Aortic dissection can place patients at risk for organ ischemia, which can start at the onset of dissection or later in the disease course and have lethal sequelae. Increased awareness of this complication, and the availability of better diagnostic tools, may improve the survival rates of patients with visceral ischemia.…”

Section: Discussionmentioning

confidence: 99%

Delayed visceral ischemia induced by type B aortic dissection

Kurumisawa

Sugaya

Akutsu

et al. 2014

Acute Medicine & Surgery

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Case: A 56-year-old man presented with a sudden severe abdominal pain 13 days after the onset of type B acute aortic dissection.Chest computed tomography revealed type B aortic dissection, and the true lumen was narrowed by the expanding false lumen. Blood flow through the celiac trunk, superior mesenteric artery, and left renal artery was reduced. Blood flow through the distal abdominal aorta and bilateral femoral arteries was clearly recognized. Laboratory findings such as transaminases were rapidly worsening.Outcome: The patient underwent emergency fenestration of the abdominal aorta and recovered without organ failure. Conclusions: Rapidly worsening laboratory findings led us to emergency operation with successful results. Serial monitoring of laboratory findings is the key for adequate timing of operation.

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“…This means that if a patient is found to have AAS based on unenhanced CT, he or she will have to undergo contrast-enhanced CT anyway to evaluate the therapeutic options, including emergency surgery. 21 Second, the positive predictive value of the unenhanced CT findings was relatively high (eg, 83.5%) when crescent, linear high density, internal displacement of intimal calcification, and TAA, the negative likelihood ratio was 0.08 and the negative predictive value was 93.3%.…”

Section: Study Limitationsmentioning

confidence: 95%