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DOI: 10.1055/s-2008-1038512
© Georg Thieme Verlag KG Stuttgart · New York
ICU Controlled Delay for Acute Type A Aortic Dissection Repair after Intervention for Total Visceral Malperfusion: A Way Out of a Dilemma?
Publikationsverlauf
Received January 17, 2008
Publikationsdatum:
09. Juli 2008 (online)
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Introduction
The prognosis for surgical repair of acute type A aortic dissection is mainly influenced by the presence of malperfusion. Visceral malperfusion certainly is associated with a grim prognosis. Rapid restoration of flow into the true lumen is one way to deal with this problem, primary restoration of abdominal perfusion using interventional fenestration or stenting another [[1], [2], [3]]. With the advent of a hybrid room integrating an angiography unit into a fully equipped operating room, for the first time it is possible to obtain immediate “on-table” information about the abdominal perfusion situation so that decisions are no longer based on hours old CT scans or mere clinical judgement. Whether or not this information warrants immediate surgical reaction is discussed below, based on two case reports.
References
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- 2 Girardi L N, Krieger K H, Lee L Y, Mack C A, Tortolani A J, Isom O W. Management strategies for type A dissection complicated by peripheral vascular malperfusion. Ann Thorac Surg. 2004; 77 1309-1314
- 3 Eggebrecht H, Baumgart D, Dirsch O, Erbel R. Percutaneous balloon fenestration of the intimal flap for management of limb threatening ischaemia in acute aortic dissection. Heart. 2003; 89 973
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Dr. Konstantinos Tsagakis
Department of Thoracic and Cardiovascular Surgery, University Hospital Essen
West-German Heart Center Essen
Hufelandstraße 55
45122 Essen
Germany
Telefon: + 49 20 17 23 49 01
Fax: + 49 20 17 23 54 51
eMail: konstantinos.tsagakis@uk-essen.de