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Late Aortic Reoperation Following Routine Transverse Arch Replacement for Type A Acute Aortic Dissection
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（Department of Cardiovascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan）
| Masanori Takamatsu |
Takashi Hirotani |
Satoshi Ohtsubo |
| Shigeyuki Takeuchi |
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We assessed the late aortic reoperation after surgery for type A acute aortic dissection（AAAD). Subjects were 108 consecutive patients with AAAD who underwent surgery by routine aortic arch replacement using geratin-resorcin-formalin-glutaraldehyde（GRF）glue between January 1996 and December 2010. Seven of the 94 patients who were discharged after the initial repair of AAAD required reoperation for the residual aorta. Reoperations included 4 procedures on the distal aorta and 3 procedures on the proximal aorta（aortic root or ascending aorta）at a mean interval of 6.1±3.5（0.9〜13.7）years after initial surgery. There were no hospital reoperation-related deaths. Freedom from reoperation was 96% and 89% at 5 and 10 years. In conclusion, the use of GRF glue may influence the risk of reoperation after surgery for AAAD, but our results showed that there were very few of such cases. Furthermore, routine aortic arch replacement for AAAD may reduce late aortic reoperations after surgery by eliminating possible risks of residual tear at the transverse arch.
Jpn. J. Cardiovasc. Surg. 42:359-363（2013）
Keywords：acute type A dissection, aortic arch grafting, reoperation, geratin-resorcin-formalin-glutaraldehyde glue
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