Surgical management of acute type A aortic dissection with cerebral malperfusion

Jian Li, W. Qin, C. Su, F. Huang
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Abstract

Objective To summarize the surgical treatment and it’s results of patients with acute type A aortic dissection with cerebral malperfusion. Methods We collected and analyzed the clinical date of 16 patients, who were hospitalized and underwent operation Between January 2010 to June 2019, presented cerebral malperfusion due to acute type A aortic dissection. All of them showed preoperative newly developed neurologic deficits, left hemiplegia in 8 cases, left paraparesis in 5 cases and right paraparesis in 3 cases. Results Aortic valve was involved in 5 patients, 2 of whom underwent AVR surgery, 2 cases of CABG and 2 cases of artificial graft bypass were performed at the same time, 1 case underwent left leg amputation postoperatively. Seven patients died after surgery. Conclusion The results of surgical management of acute type A aortic dissection with cerebral malperfusion demonstrated high hospital mortality, which needs us to restore the cerebral perfusion as soon as possible. The specific method should be decided according to the patients' condition. Key words: Acute type A aortic dissection; Cerebral malperfusion
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急性A型主动脉夹层伴脑灌注不良的外科治疗
目的总结急性A型主动脉夹层合并脑灌注不良的手术治疗及效果。方法收集2010年1月至2019年6月收治的16例急性A型主动脉夹层脑灌注不良患者的临床资料并进行分析。术前均出现新发神经功能缺损,左侧偏瘫8例,左侧截瘫5例,右侧截瘫3例。结果5例患者累及主动脉瓣,其中2例行AVR手术,2例同时行冠脉搭桥和人工搭桥,1例术后行左腿截肢。7名患者在手术后死亡。结论急性A型主动脉夹层合并脑灌注不良的手术治疗结果显示住院死亡率高,需要尽快恢复脑灌注。具体方法应根据患者的情况而定。关键词:急性A型主动脉夹层;脑malperfusion
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