Korean J Thorac Cardiovasc Surg.
2002 Dec;35(12):876-881.
Clinical Analysis of Surgical Results and Preoperative Management of Acute Aortic Dissection
- Affiliations
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- 1Department of emergency thoracic and cardiovascular surgery, gacheon medical School, Gil medical center, Korea.
- 2Department of thoracic and cardiovascular surgery, gacheon medical school, Gil medical center, Korea. sungyoul@ghil.com
- 3Department of emergency medicine, gacheon medical school, Gil medical center, Korea.
- 4Department of emergency radiology, gacheon medical school, Gil medical center, Korea.
- 5Department of emergency pediatrics, gacheon medical school, Gil medical center, Korea.
Abstract
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BACKGROUND: Acute aortic dissection associated with high mortality rate has an extremely poor prognosis if early diagnosis and treatment are not received. Recently, with advanced computed tomography and echocardiography, diagnostic rate is higher and early operation is possible. Therefore preoperative medical therapy at ER(emergency room) lowered the mortality rate. This study was done to analyze the results with preoperative management at ER and operations, retrospectively.
MATERIAL AND METHOD: A series of 42 patients treated surgically for acute aortic dissections from 1991 to 2001 were included in this study. There were 18 males and 24 females. Mean age was 51.1 years. The admission course through emergency and outpatient department(OPD) was 34 and 8 respectively.
RESULT: 26 patients underwent ascending aorta replacement-7 combined aortic valve replacements, 7 patients underwent descending aorta replacements and 9 patients received Bentall's operation. At emergency department, 20 patients received antihypertensive drugs and beta-receptor blockers and 6 patients died. 22 patients did not receive antihypertensive and beta-receptor block drugs and 10 patients died. There were 16(38%) overall deaths.
CONCLUSION
Early diagnosis at ER or OPD is essential for acute aortic dissection, and it is important to select the most appropriate noninvasive interventions as possible. Therefore, preoperative drug therapy at ER is suggested according the patient conditions.
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