Marcos Fassheber Berlinck; José Oscar Reis Brito; Salomon S. Ordinolla Rojas; Januário M. de Souza; Sérgio de Almeida Oliveira
DOI: 10.1590/S0102-76381990000100008
RESUMO
Entre janeiro de 1979 e dezembro de 1989, foram realizadas 85 operações para o tratamento da dissecção da aorta, sendo 50 na fase aguda e 35 na fase crónica. A mortalidade imediata (hospitalar) foi de 21,1% (18 pacientes), tendo como causa principal a síndrome de baixo débito cardíaco. Foi maior nos pacientes operados na fase aguda. Dentre quatro pacientes reoperados por recidiva ou dissecção em outro local, dois faleceram. Com relação à morbidade, uma paciente, reoperada por aneurisma tóraco-abdominal, apresentou paraplegia no período de pós-operatório. O seguimento tardio mostrou boa evolução dos 63 sobreviventes.ABSTRACT
Between January 1979 and December 1989, eighty five operations were performed to treat aortic dissection, including fifty in the acute phase, and thirty five in a chronic phase. The Hospital mortality was 21.1% (eighteen patients) and low cardiac output was the major cause of death. The mortality was higher in the group of patients operated upon in the acute phase. Four patients were operated upon for redissection or dissection in other localization of the aorta, and all of them died. One patient developed paraplegy in the postoperative period. The late follow-up showed good evolution in the survivors group.REFERÊNCIAS
1. ANAGNOSTOPOULOS, C. E. & KITLE, C. E. - Aortic dissection and dissecting aneurysm. Am. J. Cardiol., 30: 263-273, 1972. [MedLine]
2. BACHET, J.; GIGOU, F.; LAURIAN, C.; BICAL, O.; GOUDOT, B.; GILMET, D. - Four-year clinical experience with the gelatin-resorcine-formol biologic glue in acute aortic dissection. J. Thorac. Cardiovasc. Surg., 83: 212-217, 1982. [MedLine]
3. BENTALL, H. & De BONNO, A. - A tchnique for complete replacement of the ascending aorta. Torax, 23: 338-339, 1968.
4. BUCKBERG, G. D. - Strategies and logic of cardioplegia delivery to prevent, avoid and reverse ischemic and reperfusion damage. J. Thorac. Cardiovasc. Surg., 93: 127-139, 1987. [MedLine]
5. CABROL, C.; PAVIE, A.; GANDJBAKHCH, I. - Complete replacement of the ascending aorta with reimplantation of the coronary arteries: new surgical approach. J. Thorac. Cardiovasc. Surg., 81: 309-315, 1981 . [MedLine]
6. CABROL, C.; PAVIE, A.; GANDJBAKHCH, I. - Surgical treatment of ascending aorta pathology. J. Card. Surg., 3: 167-180, 1988. [MedLine]
7. COOLEY, D. A. ; WALTER, W. F.; LIVEDAY, J . J.; OTT, D. A. - Ressection of aortic arch aneurysms: a comparison of hypothermic technics in 60 patients. Ann. Thorac. Surg., 36: 19-28, 1983. [MedLine]
8. DAILY, P. O.; TRUEBlOOD, H. W. ; STINSON, E. B.; SHUMWAY, N. E. - Management of acute aortic dissection. Ann. Thorac. Surg., 10: 237-247, 1970. [MedLine]
9. LARSON, E. W. & EDWARDS, W. D. - Risk factors for aortic dissection: a necropsy study of 161 cases. Am. J. Cardiol., 53: 849-855, 1984. [MedLine]
10. ROBERTS, W. C. - Aortic dissections: anatomy, consequences and causes. Am. Heart J., 101: 195-214, 1981. [MedLine]
Article receive on sábado, 10 de fevereiro de 1990