| کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
|---|---|---|---|---|
| 3838360 | 1247714 | 2015 | 5 صفحه PDF | دانلود رایگان |
Surgery for thoracic aortic pathology is challenging and is associated with significant early and late mortality and morbidity. In recent decades advances in diagnostic imaging, surgical techniques, myocardial and cerebral protection and graft design have significantly improved outcomes. Patient assessment is focused on timely diagnosis and intervention to prevent the catastrophic complications. The major challenge peri-operatively is to minimize ischaemic injury to end organs, particularly the brain and spinal cord. Acute aortic dissection is the most common life-threatening thoracic aorta emergency and carries a high mortality rate with 40% of patients dying immediately. Early recognition and diagnosis of aortic dissection is therefore essential. Surgical intervention is required for ascending aortic dissection. Medical or endovascular management may be appropriate if the ascending aorta is not involved. Thoracic aortic aneurysms are usually asymptomatic and chronic in nature. Surgery is usually indicated for large or rapidly expanding aneurysms, or once a patient develops symptoms. Earlier surgery is advocated for patients with connective tissue disorders such as Marfan syndrome because of an increased risk of rupture. The advent of endovascular stent technology has opened the door for a minimally-invasive approach to the treatment of aortic pathology with encouraging early and medium-term outcomes reported.
Journal: Surgery (Oxford) - Volume 33, Issue 2, February 2015, Pages 73–77