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Acute Aortic Regurgitation Secondary to Aortic Dissection

1972; Elsevier BV; Volume: 14; Issue: 5 Linguagem: Inglês

10.1016/s0003-4975(10)65258-7

1552-6259

Hassan Najafi, William S. Dye, Hushang Javid, James A. Hunter, Marshall D. Goldin, Ormand C. Julian,

Cardiac Valve Diseases and Treatments

Emergency operations were performed in 7 adult patients for severe aortic insufficiency caused by acute aortic dissection.Dissection beginning in the aortic root involved the entire thoracoabdominal aorta in at least 3 patients.The operative findings consisted of an arch of relatively normal caliber, supravalvular intimal tear, circumferential dissection, and prolapse of the aortic cusps into the left ventricle.Repair of the proximal dissected layers and elevation of the cusps to their normal position restored valve competence in every patient.Six survivors have retained normal aortic valve function four months to six years postoperatively.The review emphasizes the feasibility of restoring aortic valve competence without using a valve substitute in treating aortic insufficiency caused by acute aortic dissection.evere aortic insufficiency is an extremely serious complication of acute aortic dissection and constitutes a major cause of death in these pa-S tients [5].In aortic arch dissection the lesion is usually initiated by a transverse intimal tear in the ascending aorta immediately superior to the aortic valve.Retrograde extension of the dissection results in displacement of the aortic cusps into the left ventricle causing aortic valve incompetence.More than 70% of the patients in this particular group die of intrapericardial rupture and cardiac tamponade [5].Fortunately, in the majority of instances there is sufficient time to make the diagnosis and to institute surgical therapy.This report demonstrates the effectiveness of early operative treatment in 7 patients with acute aortic regurgitation secondary to aortic dissection and emphasizes the feasibility of restoring valve competence without using a valve substitute. Clinical ExperienceOur group consists of 7 patients, 6 men and 1 woman, whose ages ranged from 35 to 56 years with a mean age of 47 years.The common clin-