Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection Patients
Aim: Stanford Type B acute aortic dissection (Type B-AAD) has a higher mortality among the cardiovascular diseases and the complexity of its treatment is an important challenge. The duration of dissection, whether it is complicated or uncomplicated play a determinant role in the treatment of the dis...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Mustafa Kemal University
2019-03-01
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| Series: | Mustafa Kemal Üniversitesi Tıp Dergisi |
| Subjects: | |
| Online Access: | http://dergipark.gov.tr/mkutfd/issue/44115/499838?publisher=mku |
| _version_ | 1797915408298147840 |
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| author | Deniz Demir Nail Kahraman |
| author_facet | Deniz Demir Nail Kahraman |
| author_sort | Deniz Demir |
| collection | DOAJ |
| description | Aim: Stanford Type B acute aortic dissection (Type B-AAD) has a higher mortality among the cardiovascular diseases and the complexity of its treatment is an important challenge. The duration of dissection, whether it is complicated or uncomplicated play a determinant role in the treatment of the disease. In this study, we evaluated the results of the patients that we followed and we treated due to the Type B acute aortic dissection.Materials and Methods: The study was conducted in a single center and retrospectively. The treatment strategy of the patients was determined with respect to be acute or chronic and to be complicated or uncomplicated. The patients were treated via medical treatment, thoracic endovascular aortic repair (TEVAR) or open surgery and then they were followed. The mortality and the morbidity causes of the patients were recorded.Result:Totally, 23 patients were treated due to Type B acute aortic dissection. The mean age of the patients was 58.21±14.17. The majority of the followed patients (16 patients (69.5%)) were followed with medical treatment. The patients who were followed with TEVAR treatment were in the second rank. The number of the TEVAR patients was 5 (21.7%). Two patients were treated with open surgery. 30-day survival was observed in 20 (86.9%) patients. The total mortality was seen in 3 (13%) patients.Conclusion: The twenty five percent of the patients who refer due to Type B acute aortic dissection admit due to malperfusion syndrome or hemodynamic instability. Organ malperfusion and hemodynamic instability are the most important causes of deaths of these patients. Hence, the early diagnosis of the patient and its optimal treatment is life-saving. If the patients who are treated due to the Type B acute aortic dissection are in uncomplicated type, medical treatment is in the forefront. In complicated patients, TEVAR or open surgery are recommended. In our Type B acute aortic dissection group which consists of 23 patients, the total mortality ratio was seen in 3 (13%) patients. The ratios for renal failure and for plegia were found as 4.3%. In thoracic endovascular aortic repair, no mortality was found.In conclusion, we primarily recommend conventional medical treatment for the patients in uncomplicated type in the treatment of the Type B acute aortic dissection patients. In the patients in complicated type we recommend TEVAR treatment. Since the necessary equipment for the TEVAR could not be ensured, we recommend open surgery for the emergency cases. |
| first_indexed | 2024-04-10T12:41:12Z |
| format | Article |
| id | doaj.art-ee208c3abb3b480099bc2ecb9052fd20 |
| institution | Directory Open Access Journal |
| issn | 2149-3103 |
| language | English |
| last_indexed | 2024-04-10T12:41:12Z |
| publishDate | 2019-03-01 |
| publisher | Mustafa Kemal University |
| record_format | Article |
| series | Mustafa Kemal Üniversitesi Tıp Dergisi |
| spelling | doaj.art-ee208c3abb3b480099bc2ecb9052fd202023-02-15T16:14:17ZengMustafa Kemal UniversityMustafa Kemal Üniversitesi Tıp Dergisi2149-31032019-03-0110361510.17944/mkutfd.499838102Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection PatientsDeniz Demir0Nail Kahraman1BURSA YÜKSEK İHTİSAS EĞİTİM VE ARAŞTIRMA HASTANESİ, KALP VE DAMAR CERRAHİSİBURSA YÜKSEK İHTİSAS EĞİTİM VE ARAŞTIRMA HASTANESİ, KALP VE DAMAR CERRAHİSİAim: Stanford Type B acute aortic dissection (Type B-AAD) has a higher mortality among the cardiovascular diseases and the complexity of its treatment is an important challenge. The duration of dissection, whether it is complicated or uncomplicated play a determinant role in the treatment of the disease. In this study, we evaluated the results of the patients that we followed and we treated due to the Type B acute aortic dissection.Materials and Methods: The study was conducted in a single center and retrospectively. The treatment strategy of the patients was determined with respect to be acute or chronic and to be complicated or uncomplicated. The patients were treated via medical treatment, thoracic endovascular aortic repair (TEVAR) or open surgery and then they were followed. The mortality and the morbidity causes of the patients were recorded.Result:Totally, 23 patients were treated due to Type B acute aortic dissection. The mean age of the patients was 58.21±14.17. The majority of the followed patients (16 patients (69.5%)) were followed with medical treatment. The patients who were followed with TEVAR treatment were in the second rank. The number of the TEVAR patients was 5 (21.7%). Two patients were treated with open surgery. 30-day survival was observed in 20 (86.9%) patients. The total mortality was seen in 3 (13%) patients.Conclusion: The twenty five percent of the patients who refer due to Type B acute aortic dissection admit due to malperfusion syndrome or hemodynamic instability. Organ malperfusion and hemodynamic instability are the most important causes of deaths of these patients. Hence, the early diagnosis of the patient and its optimal treatment is life-saving. If the patients who are treated due to the Type B acute aortic dissection are in uncomplicated type, medical treatment is in the forefront. In complicated patients, TEVAR or open surgery are recommended. In our Type B acute aortic dissection group which consists of 23 patients, the total mortality ratio was seen in 3 (13%) patients. The ratios for renal failure and for plegia were found as 4.3%. In thoracic endovascular aortic repair, no mortality was found.In conclusion, we primarily recommend conventional medical treatment for the patients in uncomplicated type in the treatment of the Type B acute aortic dissection patients. In the patients in complicated type we recommend TEVAR treatment. Since the necessary equipment for the TEVAR could not be ensured, we recommend open surgery for the emergency cases.http://dergipark.gov.tr/mkutfd/issue/44115/499838?publisher=mkuTip B akut aort diseksiyonutorasik endovasküler aort onarımıcerrahiType B acute aortic dissectionthoracic endovascular aortic repairsurgery |
| spellingShingle | Deniz Demir Nail Kahraman Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection Patients Mustafa Kemal Üniversitesi Tıp Dergisi Tip B akut aort diseksiyonu torasik endovasküler aort onarımı cerrahi Type B acute aortic dissection thoracic endovascular aortic repair surgery |
| title | Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection Patients |
| title_full | Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection Patients |
| title_fullStr | Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection Patients |
| title_full_unstemmed | Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection Patients |
| title_short | Short-term and Midterm Treatment Results in Stanford Type-B Acute Dissection Patients |
| title_sort | short term and midterm treatment results in stanford type b acute dissection patients |
| topic | Tip B akut aort diseksiyonu torasik endovasküler aort onarımı cerrahi Type B acute aortic dissection thoracic endovascular aortic repair surgery |
| url | http://dergipark.gov.tr/mkutfd/issue/44115/499838?publisher=mku |
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