Complications after aortic dissection surgery

Although aortic dissection is a rare disease, once it occurs, it is very harmful and can easily lead to death. In the acute phase of aortic dissection, the most common causes of death are cardiac tamponade and arrhythmia, so timely diagnosis and treatment are important. Surgery is currently the best solution, but complications are likely to occur after the operation. So, what are the complications after aortic dissection surgery?

1. Ascending aortic dissection: Ascending aortic dissection is common during and after surgery. The most serious consequence is rupture of the ascending aorta dissection, cardiac tamponade and death. If caught early, the patient can survive. Ascending aortic dissection is undoubtedly the most serious complication. The reasons may be as follows:

(1) The operation of various guidewires, catheters and delivery devices during surgery may cause damage to the aortic intima.

(2) Bare metal stent at the tip: All covered stents have a bare metal stent at the tip. The tip is sharp and in close contact with the aortic wall. As the artery pulsates, there will be a certain degree of friction between the two, which may cause new ruptures.

(3) The larger the stent, the greater the radial tension, which may cause aortic damage.

(4) Condition of the patient's own vascular wall When a patient has connective tissue disease, his or her own vascular wall is relatively fragile and cannot withstand the support of the covered stent.

2. The primary rupture is not closed: For some patients with postoperative endoleak, the false lumen can remain open for a long time, and thrombus can be partially formed inside it. The diameter of the descending aorta may be affected and may increase or not. In some patients with endoleak after surgery, the endoleak may disappear and a thrombus may form in the false lumen. Stent endoleak is a common complication. The larger the intimal rupture and the closer it is to the left subclavian artery opening, the more likely it is to have endoleak. Even if the opening of the left subclavian artery is closed, endoleak cannot be avoided.

3. Acute renal failure:

4. Cerebrovascular accident: Some patients may suffer cerebral infarction during surgery and cause hemiplegia. Patients with severe complications may suffer from cerebral hemorrhage and die, which often occurs in patients with high blood pressure after surgery. The cause of intraoperative cerebral infarction is unknown, but it may be related to the shedding of arteriosclerotic plaques and controlled hypotension during surgery. Postoperative cerebral hemorrhage is associated with hypertension. Patients with aortic dissection often have hypertension and arteriosclerosis.