医学
主动脉夹层
心脏病学
相伴的
内科学
体外循环
动脉
血运重建
外科
解剖(医学)
右冠状动脉
冠状动脉
主动脉
心肌梗塞
冠状动脉造影
作者
Ercan Eren,Mehmet Erdem Toker,Altuğ Tunçer,Cüneyt Keleş,Hasan Erdoğan,Hüseyin Anasız,Mustafa Güler,Mehmet Balkanay,Gökhan İpek,Mete Alp,Cevat Yakut
标识
DOI:10.1111/j.1540-8191.2007.00331.x
摘要
Acute aortic dissection coexisting with coronary malperfusion is a relatively rare but fatal condition. Surgical treatment of these patients is to perform early coronary revascularization concomitant with aortic repair. We review our surgical results of a selected group of 14 patients with type A acute aortic dissection and coronary artery dissection.Between January 1993 and March 2005, 14 patients (10.2%) from a total of 136 consecutive patients with acute type A aortic dissection concomitant coronary dissection were treated by performing aortic repair and coronary artery bypass grafting. There were 11 men and 3 women (mean age, 56.7 +/- 8.4 years). The right coronary artery was involved in eight patients, the left in two patients, and both coronary arteries in four patients. At admission, nine patients had Q waves (64.2%), inferior in seven (50%) and anterior or lateral in two (14.2%).Hospital mortality rate was 21.4% (3 of 14 patients). Of these, two patients could not be weaned from cardiopulmonary bypass, and one patient died of multiorgan failure in the intensive care unit.Since acute type A aortic dissection with coronary involvement is associated with high mortality rate, immediate coronary artery bypass grafting and aortic repair is a safe and reliable approach to these challenging group of patients.
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