| Reoperations after Operation
on Acute Type A Aortic Dissection |
| Hirotsugu Fukuda |
Yuji Miyamoto |
Hiroshi Takami |
| Kei Sakai |
Kenji Ohnishi |
|
(Department of Cardiovascular Surgery, Sakurabashi-Watanabe
Hospital, Osaka, Japan)
|
Reoperations after operations for
acute type A aortic dissection were performed in two cases under
deep hypothermic circulatory arrest. In case 1, the aortic arch
replacement was performed with an inclusion technique seven years
ago. The reason for reoperation was the leak from the suture
lines of all anastomosis sites. Three sites of leak were closed
putting sutures with pledgets. In case 2 the graft replacement
of the ascending aorta was performed five years ago. The reason
for reoperation was the persistent dissection from the aortic
arch to the thoracic descending aorta due to the new entry formation
at the site of the aortic clamp. At first the graft replacement
of the thoracic descending aorta was performed, followed by arch
replacement. As these conditions are preventable, we should perform
the open distal anastomosis technique without using a clamp and
graft replacement of aortic arch with the branched graft. Moreover,
deep hypothermic circulatory arrest may appear to be a valuable
adjunct for reoperation after operation on acute type A dissection.
Jpn. J. Cardiovasc. Surg. 31: 217-220 (2002) |
|
