Staged repair of extensive XXXX .

@entity1 @entity449 @entity51 @entity7105 @entity439
BACKGROUND: We adopted a two-stage approach ( @entity7105 trunk procedure) in the repair of extensive @entity449 in 1991, performing 241 procedures in 155 @entity1 . METHODS: Reversed @entity7105 trunk (graft replacement of the descending thoracic aorta followed by ascending/arch replacement) was performed in 18 @entity1 . All other @entity1 underwent conventional staged repair. The first stage was performed in 137 @entity1 , with 86 @entity1 returning for the second stage. RESULTS: First stage 30-day mortality was 9.5% (13 of 137). There was no second stage immediate @entity51 . Second stage mortality was 7.0% (6 of 86). During the interval of 31 days to 6 weeks after stage one, mortality was 10 of 124 (8%). Seven of the 10 interval deaths (70%) were due to rupture of the untreated aortic segment. The mortality rate was 32.1% (18 of 56) in the group of @entity1 who did not return for the second stage repair. CONCLUSIONS: Extensive @entity449 can be repaired with acceptable morbidity and mortality using the @entity7105 trunk technique. After stage one, prompt treatment of the remaining @entity439 is crucial to success.
