Harran Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi AD, Şanlıurfa

Background: In this study, we aimed to evaluate our six-case experience in the proximal aortic dissection management. Methods: We operated on six patients (1 female, 5 males; mean age 54.2±14.4 years; range 36 to 72 years) of Stanford type-A aortic dissection between August 2007 and November 2008. Right femoral, aortic or axillary artery canulation and isothermic blood cardioplegia were used. Distal anastomoses were completed by cross-clamp or open technique using reinforcement with teflon felt. In case of an insufficiency in the aortic valve, the aortic root was repaired by applying biological tissue glue and commissural suture resuspension. Results: In five cases, we used both echocardiography and contrast enhanced thoracic computed tomography for diagnosis. In one case, only contrast enhanced thoracic computed tomography was preferred. While in five cases, interposition of tubular graft was used to repair the ascending aorta, in one case, the ascending aorta and hemiarch replacement was performed. In five cases, resuspension sutures were placed due to aortic insufficiency. The mortality rate was 33.3% (n=2). Conclusion: We consider that early diagnosis, the anastomosis reinforced with teflon felt, aortic remodeling together with resuspension suture and axillary artery cannulation are safe applications in the management of acute proximal aortic pathologies.