J.Jpn. Surg. Soc.. 81(9): 979-983, 1980
Report on the annual meeting
TREATMENT OF DISSECTING AORTIC ANEURYSMS
－NEW SURGICAL TREATMENT OF DISSECTING AORTIC ANEURYSMS－
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Department of Thoradic Surgery, Faculty of Medicine, Tokyo University, Tokyo Hideo Okabe, Akira Ueno, Masahiro Saigusa |
The average age in this group of patients was 58 years, with a range from 28 to 73 years. There were 36 male patients and 21 females.
Initially, surgical or medical therapy was generally selected after consideration of the patients'condition and evaluation of complications from dissection such as aortic insufficiency, renal artery involvement or mesenteric ischemia. These complications placed the patient into the surgical group.
37 patients were treated surgically.
Recently in 8 patients of DeBakey Type I and type IIIb, a new form of surgical treatment has consisted of wrapping over the dissecting aortic aneurysm, fenestration below the renal artery, and prosthetic graft interposition. If complications such as aortic insufficiency, renal involvement, or mesenteric ischemia were present, reconstruction of the aortic value, renal artery, celiac or superio mesenteric artery was performed.
This new surgical treatment is a one-or-two-stage operation.
One patient of DeBakey IIIb died after the dissection ruptured into the left pleural space before wrapping the dissecting descending aortic aneurysm. He was waiting for the second-stage operaton.
One patient of DeBakey IIIb died of renal and cardiac insufficiency.
6 patients survived beyond the period of hospitalization. The periods of follow-up ranged from 1 year to 4 years.
Histologically, after the dissecting aortic aneurysm was wrapped by Dacron Mesh, this aneurysm was covered with adventitial tissue outside the Dacron Mesh.
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