Abstract
Surgical therapy for acute dissection of the ascending aorta has had a high mortality. The contributing factors have been hemorrhage from the suture lines and pulmonary dysfunction following a prolongation of extra corporeal circulation (ECC) time. A method of treatment with an intraluminal prosthesis that requires no end-to-end anastomosis has been developed. We have used this method in two patients, who had acute aortic dissections type I and high risks. The first case involved a patient of advanced age and had poor pulmonary function. The second case involved a patient with poor liver function and decreased blood platelet count. The sutureless fixations shortened ECC times which were 98 and 107 minutes in the first and second cases, respectively and reduced blood loss. There were neither hospital deaths nor early graft-related complications. Our experience with these cases suggests that grafting of the aorta is less hazardous with the sutureless than with the conventional sutured anastomosis technique in the high risk patients.
