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CC BY 4.0 · Aorta (Stamford) 2015; 03(06): 191-194
DOI: 10.12945/j.aorta.2015.15.007
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Principles for Management of Intraoperative Acute Type A Aortic Dissection

Philemon Gukop
1   Department of Cardiothoracic Surgery, St George’s Hospital NHS Trust, London, United Kingdom
,
Vankatachalam Chandrasekaran
1   Department of Cardiothoracic Surgery, St George’s Hospital NHS Trust, London, United Kingdom
› Author Affiliations
Further Information

Publication History

25 February 2015

06 October 2015

Publication Date:
24 September 2018 (online)

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Abstract

Intraoperative Type A aortic dissection is a rare pathology with incidence of 0.06–0.32%. It is associated with a high mortality between 30–50%. Some associated risk factors, including hypertension, enlarged aorta, peripheral vascular disease, advanced age, atheroma, and high arterial pressure on cardiopulmonary bypass, have been identified. Modification of these risk factors could reduce the incidence of this event. Prompt diagnosis and management, with the aid of intraoperative trans-esophageal echocardiography and/or epi-aortic ultrasound has been shown to reduce the mortality to 17%. We illustrate the principles of management of this pathology with the case of a 62-year-old female who developed acute Type A aortic dissection while undergoing minimally invasive mitral valve repair.

Key Words

Aortic dissection - Aortic operation - Surgical complications - Practice guidelines (aorta) - Perioperative care
 

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