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Clinical treatment of acute type-A aortic dissection with lower limb malperfusion / 中华胸心血管外科杂志
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 593-596, 2018.
Article in Chinese | WPRIM | ID: wpr-711847
ABSTRACT
Objective To explore the treatment experience of acute type-A aortic dissection with lower limb malperfusion.Methods From December 2012 to December 2016,479 cases of acute type A aortic dissection were treated surgically,including 39 patients with lower limb ischemia,including 27 males and 12 females,with mean age of(5 1.4 ± 12.4) years.All patients were treated with deep hypothermic circulatory arrest and were treated with single pump,double-tube and double-injected limbs.According to the patient's lower limb ischemia time,symptoms and signs,limb ischemia was assessed.If necessary,femoral artery-femoral arterial bypass was performed.For patients undergoing femoral arterial-femoral prosthetic bypass during the same period,postoperative follow-up monitoring,if necessary,secondary femoral-femoral arterial vascular bypass or osteofascial decompression.Results Early mortality rate was 17.9% (7/39).32 cases of postoperative survival.The follow-up rate was 93.8% (30/32),3 months to 3 years after the operation,the results were satisfactory.The over lower limb malperfusion recovery rate of follow-up patients was 96.7% (29/30).Conclusion Positive operation for acute type-A aortic dissection with lower limb malperfusion is safe,feasible and effective.Concomitant or secondary bypass procedures are also possible to restore distal perfusion when necessary.Comprehensive evaluation of patient' s status is strongly recommended for optimal surgical decision making.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Thoracic and Cardiovascular Surgery Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Thoracic and Cardiovascular Surgery Year: 2018 Type: Article