초록접수 현황
| 15F-198 | 구연 발표 |
Clinical Outcomes of Traumatic Aortic Dissection ; Single Center Experience
이성준, 김준석, 신제균, 지현근
건국대학교 의과대학 건국대학교병원 흉부외과학교실
Background : Blunt aortic injury rarely occurs in isolation. Because there is a substantial increase in mortality in patients with co-existing multiple trauma, the timing of aortic procedure may be important.
Methods : We identified 567 patients performed aorta surgery between august 2007 and august 2015. Of these, 23 patients diagnosed with traumatic aortic dissection. Aortic injuries was graded according to Society for Vascular Surgery guidelines(grade I-IV). Postoperative outcomes and intraoperative cardiopulmonary bypass methods were reviewed.
Results : The mean age were 38.9±18.6 years(range 10 to 69, 19 male). The causes of aortic injury were traffic accident 21 cases and fall down 2 cases. The most common aortic injuries were aortic dissection at the level of isthmus in 18 patients(78.3%). Another level of aortic dissections were ascending aorta in 2 patients(8.7%), aortic arch in 2 patients(8.7%) and descending aorta 1 patient(4.3%). 18 patients was performed open repair(Grade II-IV). 5 patients(Grade I-II, 21.7%) with small intimal flaps and small pseudoaneurysm have been managed medically. Open surgical repair was performed under on pump beating heart with distal perfusion in 11 patients(Beating group,61%) and total circulatory arrest without proximal clamp in 4 patients(TCA group, 39%). The duration after trauma to operation were 15.9±17.5 day(Beating group) and 33.0±20.9 days(TCA group) without statistical differences. One(4.3%) mortality was observed(in-hospital, due to multi organ failure).
Conclusion : Although early operation is reasonable in patients with grade III-IV aortic injury, the timing of open repair of aortic injury should be decided according to co-existing trauma.
Methods : We identified 567 patients performed aorta surgery between august 2007 and august 2015. Of these, 23 patients diagnosed with traumatic aortic dissection. Aortic injuries was graded according to Society for Vascular Surgery guidelines(grade I-IV). Postoperative outcomes and intraoperative cardiopulmonary bypass methods were reviewed.
Results : The mean age were 38.9±18.6 years(range 10 to 69, 19 male). The causes of aortic injury were traffic accident 21 cases and fall down 2 cases. The most common aortic injuries were aortic dissection at the level of isthmus in 18 patients(78.3%). Another level of aortic dissections were ascending aorta in 2 patients(8.7%), aortic arch in 2 patients(8.7%) and descending aorta 1 patient(4.3%). 18 patients was performed open repair(Grade II-IV). 5 patients(Grade I-II, 21.7%) with small intimal flaps and small pseudoaneurysm have been managed medically. Open surgical repair was performed under on pump beating heart with distal perfusion in 11 patients(Beating group,61%) and total circulatory arrest without proximal clamp in 4 patients(TCA group, 39%). The duration after trauma to operation were 15.9±17.5 day(Beating group) and 33.0±20.9 days(TCA group) without statistical differences. One(4.3%) mortality was observed(in-hospital, due to multi organ failure).
Conclusion : Although early operation is reasonable in patients with grade III-IV aortic injury, the timing of open repair of aortic injury should be decided according to co-existing trauma.
책임저자: 지현근
건국대학교 의과대학 건국대학교병원 흉부외과학교실
연락처 : 이성준, Tel: 010-6436-2217 , E-mail : 20150060@kuh.ac.kr
