초록접수 현황
| 15F-003 | 구연 발표 |
The Long Term Result of Aortic Arch Replacement and Ascending Aortic Replacement in Acute Debakey Type I Aortic Dissection.
조광조, 우종수, 방정희, 박권재, 박종윤, 윤성실
동아대학교 의과대학 동아대학교병원 흉부외과학교실
Background : The surgical strategy of the extension of aortic replacement in acute DeBakey type I aortic dissection is controversy. To find the difference of the distal aortic change with the extension of aortic replacement, we analyzed the long term result of the ascending aortic replacement and arch aortic replacement in acute DeBakey type I aortic dissection.
Methods : We analyzed 143cases of acute DeBakey type I aortic dissection(1996-2015). Among them 101 patients underwent ascending aortic replacement and 42 patients underwent arch aortic replacement. The surgical mortality was 20case and we follow up 123 patients with the mean follow up period of 6.9 +/- 13.3 years. Despite the follow up loss cases, 101 patients was checked CT angiogram and the duration of final CT check period was 4.6 +/- 3.0 years.
Results : There were 15 cases of reoperation in 13 patients. 13 cases were in the ascending aortic replaced group and 2 cases were in the arch aortic replacement group. There were 13 late mortality cases. 10 cases were acending aortic replaced group and 3 cases were arch replcement group. Among the ascending aortic replacement group 8 cases were die of distal aortic problem, but only 1 case of arch replacement group was die of abdominal aortic rupture. The follow up CT angiogram shows 63.3% of ascending aortic replacement group and 34.3% of arch aortic replacemen group developed dista aortic aneurysm (p=0.0024). The rement arch and proximal descending aorta was predominent area of aneurymsal change in the ascending aortic replacement group.
Conclusion : The arch aortic replacement was superior to the ascending aortic replacement in terms of distal aortic aneurysma development and freedom from late aortic reoperation and long term mortality from distal aortic events.
Methods : We analyzed 143cases of acute DeBakey type I aortic dissection(1996-2015). Among them 101 patients underwent ascending aortic replacement and 42 patients underwent arch aortic replacement. The surgical mortality was 20case and we follow up 123 patients with the mean follow up period of 6.9 +/- 13.3 years. Despite the follow up loss cases, 101 patients was checked CT angiogram and the duration of final CT check period was 4.6 +/- 3.0 years.
Results : There were 15 cases of reoperation in 13 patients. 13 cases were in the ascending aortic replaced group and 2 cases were in the arch aortic replacement group. There were 13 late mortality cases. 10 cases were acending aortic replaced group and 3 cases were arch replcement group. Among the ascending aortic replacement group 8 cases were die of distal aortic problem, but only 1 case of arch replacement group was die of abdominal aortic rupture. The follow up CT angiogram shows 63.3% of ascending aortic replacement group and 34.3% of arch aortic replacemen group developed dista aortic aneurysm (p=0.0024). The rement arch and proximal descending aorta was predominent area of aneurymsal change in the ascending aortic replacement group.
Conclusion : The arch aortic replacement was superior to the ascending aortic replacement in terms of distal aortic aneurysma development and freedom from late aortic reoperation and long term mortality from distal aortic events.
책임저자: 조광조
동아대학교 의과대학 동아대학교병원 흉부외과학교실
연락처 : 조광조, Tel: 051-240-2879 , E-mail : kwangjocho@gmail.com
