Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aortic dissection with an entrance tear in the transverse aorta is generally considered to have the highest acute fatality rate of any type of dissection and the direction of its extension is the most difficult to predict. In a prospective study, we evaluated 61 consecutive patients (mean age 56.7 years, ranging from 21 to 75 years), presenting with ascending aortic dissection during a 36-month-period and tried to clarify the incidence of retrograde ascending aortic dissection. In 49 patients (80.3%), the intimal tear was located in the ascending aorta, whereas the dissection originated in the transverse aorta in 12 patients (19.7%); in this latter group, extension was strictly retrograde in 5 patients and in both directions in 7 patients. Three patients died before operation; 58 patients underwent aortic replacement/repair under moderate hypothermia; if the primary tear extended into the transverse aorta or was not found in the ascending aorta, the aortic arch was explored during a brief period of deep hypothermic circulatory arrest. The overall operative mortality was 12.1% (7/58); it was 10.4% (5/48) in ascending aortic dissection and 20% (2/10) in dissection of the transverse aorta. Age (P < 0.005), concomitant coronary artery disease (P < 0.01) and the site of intimal tear (P < 0.01) were significant predictive factors of operative risk. A tear in the transverse aorta is almost always associated with retrograde dissection and may simulate dissection with the entrance tear in the ascending aorta. Localization of the entrance tear remains a diagnostic challenge in aortic dissection but Doppler-echocardiography had a high sensitivity in this series (96.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Retrograde ascending aortic dissection: a diagnostic and therapeutic challenge. 846 Nov 47

Aortic dissection is severe disease, but recently surgery of aortic dissection is reported in good results. In order to improve results, three adjunctive methods have been progressed recently; intraoperative color Doppler retrograde cerebral perfusion and deep hypothermia. Intraoperative color Doppler reveals dynamic hemodynamics and structural information in aortic dissection in real time which leads to proper surgical treatment to obtain maximum effects with minimum invasiveness. To carry out thrombus obliteration in false lumen by informations of intraoperative color Doppler leads to a healing in aortic dissection. Retrograde cerebral perfusion during surgery of aortic dissection permitted simple procedure and good surgical results with reduced neurological complications. Deep hypothermia for protection of spinal cord and other organs also yielded good operative results and reduced rate of paraplegia.
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PMID:[Recent progress in adjunctive methods during surgery of aortic dissection]. 896 92

Type A Aortic Dissection is a medical-surgical emergency which requires prompt diagnosis and adequate treatment. Since its inception--more than 40 years ago--the surgical treatment has evolved up until now, when it offers an immediate solution to the high mortality rate due to complications, with acceptable morbidity and mortality rates. This improvement is due also to better diagnostic techniques, postoperative management and profound hypothermia with circulatory arrest. The basic techniques to achieve this consist of resection of the entry tear and closure of the false lumen and repair of the aortic regurgitation when present. Failure of them--proximally or distally--leads to persistence of the false lumen and the possibility of complications or late reoperations. The long-term follow-up, monitorized by non-invasive methods, is mandatory to decide the proper management.
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PMID:[Surgery of type A acute aortic dissection. Past, present and future]. 905 38

Ischemic cerebrovascular diseases are commonly induced by atherosclerosis and cardiogenic embolization but rarely they occur in association with Takayasu's arteritis and aortic lesion such as aortic dissection and aneurysm. Here we experienced two cases of acute aortic disease complicated by ischemic cerebrovascular disease (CVD). Patient 1 was a 77-year-old male. He complained of dyspnea and left hemiparesis. He was brought to our hospital by ambulance. Left hemiparesis and dyspnea improved soon. The patient only complained of left lower extremity pain and physical examination revealed hypotension. Brain CT showed no abnormality but chest CT revealed aortic dissection. The resection of the intimal tear and replacement of ascending aorta and aortic arch with 28 mm Hemashield graft were performed under hypothermia and selective cerebral perfusion. The postoperative course was uneventful and he has been doing well. Patient 2 was a 67-year-old female. She was found lying unconscious and brought to our hospital by ambulance. Physical examination revealed right hemiparesis and hypotension. Brain CT demonstrated low density area in the left corona radiata and ruptured aortic aneurysm was seen in abdominal CT. Just after the examination, the patient suddenly complained of severe back pain and died despite cardiopulmonary resuscitation. Aortic lesions can manifest ischemic symptom involving multiple organs following their vascular disorder. Aortic dissection rarely occurs in association with ischemic CVD and in that case it is likely to be seen by neurologists. Aortic dissection and aneurysm deteriorate so suddenly that immediate diagnosis and proper treatment are needed.
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PMID:[Two cases of acute aortic disease complicated by ischemic cerebrovascular disease]. 1076 48

Cardiac surgery using cardiopulmonary bypass in patients with advanced liver cirrhosis has been infrequently performed, and reported to be too risky. Aortic dissection accompanied with liver cirrhosis is extremely rare. A 61-year-old woman who had aortic dissection and Child B liver cirrhosis underwent ascending aorta replacement. Liver protection during cardiopulmonary bypass was successfully accomplished by moderate hypothermia and use of an aortic occlusion balloon to maintain sufficient hepatic blood flow.
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PMID:Stanford type A aortic dissection with Child B liver cirrhosis. 1754 Sep 80

Aortic dissection is a life-threatening disease that requires immediate surgical intervention. Marfan syndrome is a hereditary disease with an autosomal dominant transmission, which affects the connective tissue, with skeletal, cardiovascular and ocular involvement. It is one of the most prevalent connective tissue disorders, presenting a risk of aortic dissection of approximately 1% even without dilatation of the aorta. When dissection occurs during pregnancy and requires surgical intervention (type A dissection), maternal mortality is high (2096-30%). We report a 38 year-old woman with Marfan syndrome that had an acute type A aortic dissection and severe aortic regurgitation at 37 weeks of gestation. The patient underwent a cesarean section and delivered a healthy baby. Afterwards, aortic valve repair and ascending aortic replacement was successfully performed under circulatory arrest with deep hypothermia. Additionally mitral valve repair for degenerative disease with posterior, autologous pericardium mitral valve ring was performed.
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PMID:[Acute type A aortic dissection in pregnant patient with Marfan syndrome. Report of one case]. 1939 29

The German Registry for Acute Aortic Dissection Type A (GERAADA) as an international registry for acute aortic dissection type A (AADA) offers a unique opportunity to answer questions regarding acute dissections that cannot be answered by single institution's database alone. GERAADA was started in 2006 by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS) and has collected more than 3,300 AADA patients' data from 56 centers in Germany, Austria, and Switzerland up to now. In the second generated validated dataset comprising the years from 2006 to 2010, 2,137 patients were surgically treated for AADA with an overall 30-day mortality of 16.9%, and a new postoperative neurologic dysfunction of 9.5%. Risk factors for neurologic dysfunction were malperfusion syndromes, dissections of the supra-aortic vessels, and longer operating time. Neuroprotective drugs had no influence on stroke rates. Hypothermic circulatory arrest and antegrade selective cerebral perfusion (ACP) led to similar results if arrest times were less than 30 minutes while ACP for longer arrest periods is advisable. Septuagenarians had an early mortality rate (15.8%) similar to the whole cohort's, but the mortality rate in octogenarians (34.9%) was much higher. GERAADA with its validated 2,137 patient files (2006-2010) is the largest database on AADA worldwide and continues to collect data. Structured follow-up of more than 5 years will be available in the future.
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PMID:German Registry for Acute Aortic Dissection Type A: Structure, Results, and Future Perspectives. 2697 9