Stanford A型急性大動脈解離に対する基部再建術の手術成績

Surgical Outcomes for Aortic Root Repair in Patients Undergoing Type A Acute Aortic Dissection

上行大動脈に解離が及ぶStanford A型急性大動脈解離（AAD）はきわめて予後不良で，症状の発現から1時間あたり1～2％の致死率があると報告されている1）．発症直後から経時的な変化を起こし，広範囲な血管に病変が進展するため心タンポナーデ・心筋梗塞・脳虚血・対麻痺・下肢虚血などの種々の病態を示すことが多い．大動脈基部への解離進展もしばしば見受けられ，基部再建術を行うことも増えてきている．基部再建

We evaluated retrospectively 11 consecutive patients who underwent emergent aortic root operations for acute aortic dissection from April 2012 to March 2017. We underwent Bentall operation in 6 patients and Florida Sleeve repair in 3 patients and aortic root replacement with a Freestyle stentless porcine valve in 2 patients. The 30-day mortality of emergent aortic root operations was 9.1％（1 of 11）, and the hospital mortality was 18.2％（2 of 11）. The Overall survival at 5 years was 90.0％. In conclusion, the aortic root repair can be performed safely in acute aortic dissection.