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Biomedical subjects

Anthony L Estrera

Publications and source records attributed to Anthony L Estrera.

39 records · Page 3Linked to original sources
PubMed2002

Is acute type A aortic dissection a true surgical emergency?

Untreated acute aortic dissection involving the ascending aorta (type A) is associated with a high early mortality owing to rupture. Despite advancements in surgical technique and critical care, early mortality remains high. Operative mortality may be related to the technical challenges associated with intervening on the acutely dissected aorta as well as the multiorgan insult it induces. In this article, we review our approach to acute type A aortic dissection with regard to diagnosis, initial medical management, surgical repair, and timing of repair.

Acute Disease↗
PubMed2002

Thoracoabdominal and descending thoracic aortic aneurysm surgery in patients aged 79 years or older.

OBJECTIVE: Advanced age has been reported as a predictor of increased morbidity and mortality in patients who undergo major cardiovascular reconstructive surgery. In this study, we evaluated the outcome of patients aged 79 years or older after thoracoabdominal and descending thoracic aortic aneurysm repair. METHODS: From February 1991 to May 2001, 854 patients underwent operation for thoracoabdominal or descending thoracic aortic aneurysm. Fifty-six patients were between the ages of 79 and 88 years at the time of surgery, and these patients were included in this study. Risk factors were analyzed for their impact on mortality and morbidity in these elderly patients with univariate analysis. RESULTS: In patients at low risk, the 30-day mortality rate was 7/42 (17%), compared with 7/14 (50%) in patients at high risk with emergency presentation, congestive heart failure, or diabetes (P <.03). Four patients (7%; 4/56) had neurologic deficits develop. No single preoperative risk factor was significantly associated with increased mortality or neurologic deficits. CONCLUSION: Thoracoabdominal and descending thoracic aortic aneurysm repair in elderly patients can be undertaken with acceptable mortality and morbidity, provided that patients are selected appropriately.

Age Factors↗