| Guie-Young Lee | 2 Articles |
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[English]
Acute type A arotic dissection is a condition which requires emergency surgery. Surgeons want to know not only the extent of the disease but also the exact site of intimal tear as well as the presence of side branch involvement to plan the extent of surgery. Various non-invasive diagnostic tools(transthoracic and transesophageal echocardiography, conventional and spiral computed tomography and magnetic resonance imaging) and invasive angiography are available for the evaluation of the extent of dissection, site of intimal tear and side branch involvement. Each technique has its advantage and disadvantage. Especially, MRI has been accepted as a gold standard for the diagnosis of aortic dissection, but it is immobile and sometimes it cannot give us the information about the small intimal tear site. Transesophageal echocardiography has the advantage of movability and high resolution in addition to the ability of providing comprehensive information about the cardiac function. Because of these advantages, it has been widely utilized for the evaluation of patients with aortic dissection. We performed preoperative transesophageal echocardiography in addition to computed tomography in 3 cases of acute type A aortic dissection and report these cases with the review of articles.
[English]
As the number of elderly people rises, the incidence of surgery in elderly patients would become higher. This study was undertaken to examine the changes in pulmonary gas exchange that occurs with advancing age. Arterial blood gases were analysed in 106 elderly patients over the age of 65 and 40 adult patients(control group) during breathing of room air preoperatively. Alveolar oxygen partial pressure(PAO2), alveolar-arterial partial pressure gradient for oxygen(AaDO2), arterial/alveolar oxygen partial pressure(a/A) ratio were calculated using PaO2 and PaCO2 and PAO2 and measured the relationship between the PaO2 and age. PaO2 declined as age increased significantly and the regression equation was PaO2=103.6-0/332×age(r=0.55). There was no significant difference in PaCO2 and PAO2 but AaDO2 increased and a/A ratio decreased significantly. As the AaDO2 and a/A ratio were changed significantly, it is necessary for monitoring of oxygenation during perioperative periods in elderly patients.
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, Tae-Hee Won
