Recent surgical outcomes of acute type-A aortic dissection.

The aim of this study is to assess the early outcome of the surgical treatment of acute type-A aortic dissection using recent improvements in antegrade selective cerebral perfusion. This study included 38 patients who had undergone surgery for acute type-A aortic dissection from October 2003 through March 2006. The surgery results were evaluated in 2 groups: group A was composed of those who had undergone the surgery before the procedures of antegrade selective cerebral perfusion was changed in December 2004, and group B consisted of those who had the surgery after the change. Operations were performed with hypothermic cardiopulmonary bypass, antegrade selective cerebral perfusion during the arch repair, and open distal anastomosis. Times to awakening after the surgery were 27.6±26.2 hours in group A and 19.8±22.3 hours in group B (p= 0.5). Intubation times were 8.55±7.09 days in group A and 5.11±2.56 days in group B (p=0.06). Permanent neurologic dysfunction was observed in 3 patients in group A and 1 in group B (p=0.6). Transient neurologic dysfunction was observed in 4 patients each in groups A and B (p=1). Mortality rates were 21.1% in group A and 10.5% in group B (p=0.65). There were no significant differences in mortality or morbidity between the two groups, but the intubation time tended to be shorter in group B.